世界经济论坛-第一癌症护理：利用第四次工业革命技术进行癌症护理（英）-2022.2-40页_8mb

Summary of FIRST Cancer Care: Leveraging Fourth Industrial Revolution Technologies

Core Content

The FIRST Cancer Care initiative, developed by the World Economic Forum in collaboration with various stakeholders in India, aims to transform cancer care using technologies from the Fourth Industrial Revolution (4IR). The initiative is part of a broader FIRST Healthcare strategy that seeks to improve health outcomes through the integration of innovative technologies such as artificial intelligence (AI), internet of things (IoT), and blockchain.

Main Objectives

• To address the increasing burden of cancer in India.
• To improve early diagnosis, treatment, and patient care through technology.
• To develop a National Oncology Data Model (ODM) that ensures interoperability, standardization, and privacy.
• To create a Cancer Care Value Pathways (CCVP) framework for planning and implementation.
• To foster a multistakeholder approach involving government, industry, academia, and civil society to ensure equitable and sustainable healthcare.

Key Areas of Focus

1. Cancer Spread in India

• Cancer incidence is rising due to lifestyle changes, tobacco use, and an aging population.
• Breast, cervical, and stomach cancers are the leading causes of disability-adjusted life-years (DALYs) lost among women.
• Lung, lip and oral cavity, and pharyngeal cancers are the top contributors to DALYs lost among men.
• The crude incidence rate of cancer increased by 28.2% from 1990 to 2016.
• Kerala and Mizoram had the highest incidence rates in 2016.

2. Critical Gaps in Cancer Care

The initiative identified six major gaps in cancer care:

• Data: Lack of complete and standardized cancer data, especially in rural areas.
• Diagnosis: Limited awareness and training among community physicians, and the high cost of diagnostic services.
• Knowledge and Skills: Insufficient training for healthcare professionals in cancer diagnosis and treatment.
• Financing: High out-of-pocket expenditure (OOPE) and limited insurance coverage for outpatient department (OPD) services.
• Patient Journey: Delays in seeking care due to lack of awareness and poor access to information.
• Human Resources: Shortage of trained healthcare professionals and fragmented service delivery.

3. Proposed Interventions

• Oncology Data Model (ODM): To capture and standardize cancer data across the patient journey.
• Four Cancer Care Value Pathways:
  • Population Health Pathway: Focus on prevention, early detection, and public health intelligence.
  • Health Professional Education Pathway: Enhance knowledge and skills of healthcare workers through MOOCs and training.
  • Provider Pathway: Improve the efficiency and effectiveness of healthcare providers using AI and IoT.
  • Data Pathway: Ensure interoperability and alignment with the Ayushman Bharat Digital Mission (ABDM).

4. Implementation Strategy

• The initiative proposes pilots at the district level for each state.
• Successful pilots will be scaled up across the state.
• Emphasis on cost-effective technologies and ethical adoption.
• The role of central and state governments is critical in driving and supporting the initiative.

Key Information

• Healthcare Challenges in India:

  • Low public spending on healthcare (1.3% of GDP).
  • Shortage of health professionals and facilities.
  • Large urban-rural divide in access to health services.
  • High OOPE and financial burden on patients and families.

• Technological Solutions:

  • AI for faster and more accurate diagnosis.
  • IoT for remote patient monitoring.
  • Blockchain for secure and transparent data management.
  • FHIR standards for interoperability in health data.

• Importance of Data:

  • The lack of reliable and standardized data is a major barrier to effective cancer care.
  • The ODM will ensure data is captured at every stage of the patient journey and shared securely among authorized stakeholders.

• Multistakeholder Collaboration:

  • A core group of experts from government, industry, academia, and civil society has been established.
  • The initiative aims to solve for India, solve for the world, emphasizing global relevance and scalability.

• Financial Barriers:

  • Over 40% of households in public hospitals use distress financing to pay for cancer treatment.
  • There is a need for better insurance coverage and risk pooling mechanisms to reduce OOPE.

Conclusion

The FIRST Cancer Care report outlines a comprehensive strategy to leverage 4IR technologies in transforming cancer care in India. It emphasizes the need for a multistakeholder approach, data standardization, and financial sustainability to ensure equitable and effective cancer care. The initiative also highlights the importance of prevention, early detection, and palliative care as part of a broader healthcare transformation. The proposed Oncology Data Model and value pathways are key to achieving these goals, with a focus on pilot implementation and scaling up successful interventions.

Appendix

• Abbreviations:

  • AI: Artificial Intelligence
  • IoT: Internet of Things
  • FHIR: Fast Health Interoperability Resources
  • ABDM: Ayushman Bharat Digital Mission
  • ODM: Oncology Data Model
  • CCVP: Cancer Care Value Pathways

• Stakeholders:

  • Clinicians, IT companies, pharmaceutical firms, public health professionals, and civil society representatives have been involved in the initiative.

Acknowledgements

The initiative is a result of collaborative efforts involving over 30 stakeholders and 45 meetings to develop a robust and scalable strategy.

Endnotes

• The report draws on data from the National Cancer Registry Programme (NCRP) and other national health initiatives.
• It also highlights the role of digital health in improving cancer care outcomes and reducing financial burden on patients.