National Academies on Promoting Health Equity in Cancer Care: Commendable Yet Untapped Potential for Digital Technologies in Achieving Health Equity

The latest report by the National Academies on “Promoting Health Equity in Cancer Care” is an assertive statement by the country’s leading scientists advocating for promoting health equity in cancer care. The report is significant for a few reasons. First, it stresses the importance of social determinants of health to get more holistic views of disparities. This is particularly important because, despite advances in clinical delivery and biomedical advances in cancer care, disparities in cancer incidence and outcomes persist due to factors beyond hospitals and clinics—physical, social, and work environments. Second, the report provides a framework for operationalizing and realizing equity, especially including patient voice, and strengthening community engagement. Institutions making commitments to support equity and to implement such commitments are indeed noteworthy, and they can utilize the report to change the current structures that sustain current inequities in cancer research and care delivery. And third, the report highlights the importance of leveraging National Cancer Institute (NCI)-designated cancer centers to improve cancer equity. It notes that NCI-designated cancer centers can further address structural racism in health through multi-sector partnerships from urban planning experts to address transportation issues to working with legal expertise to address issues of housing instability.

We at ConcertAI agree with many of the perspectives shared in the report. In fact, the ideas and solutions squarely align with ConcertAI’s mission, culture, and actions. We have dedicated ourselves to health equity and trial diversity in oncology, including efforts to eliminate research inequities—an initial step to eliminate treatment and care disparities begins through our ERACE program. We have been assessing racial, ethnic, and economic burdens across all major cancers and have brought these insights into all our work and data solutions. For example, ConcertAI now aligns Social Determinants of Health Data to all its datasets and retrospective studies.  We will soon be able to do the same for our Digital Clinical Trial Solutions.

However, we believe the report and its authors miss important, contemporary, technology-driven approaches in digital health that can function as accelerators of the principles and goals of health equity. These approaches leverage the greater accessibility and higher refresh rates of Real-World Data (RWD) and AI SaaS technology-enabled approaches that we believe will be increasingly integral to healthcare providers’ clinical and research workflows and the hallmarks of their partnerships with biomedical innovators. The COVID-19 pandemic reinforced this conclusion that healthcare organizations need to pivot hard to digital solutions to overcome structural inequities. Case in point—ConcertAI is leveraging technologies in partnership with medical organizations like the NCI Community Organization Research Program (NCORP) and biopharma in promoting more equitable research by assuring that our data are representative, that our technologies explicitly remediate racial and ethnic biases, and that we proactively contribute to the elimination of research and health inequities.

Also, we see these technologies and approaches as providing critical and consistent capabilities outside of the traditional settings of biomedical research, the academic medical centers, and enabling research and augmented clinical decision support solutions to move into the community where 70 to 80% of patients receive their care. As the FDA and other health authorities encourage trial populations to be more representative of the total population that might receive a specific medicine once approved, these solutions are both the enablers of, and absolutely consistent with, the broadened access that is fundamental to any national equity initiative.

Without these data and technology solutions, we are unable to truly understand the current state; improve upon the current standard of care outcomes across settings and groups; nor define ‘equitable’ from an epidemiological and statistical baseline. Advanced RWD solutions and digital technologies are the bridges connecting many of the key points advanced in the report as central to realizing the vision of health equity.