Implementing a digital platform for patient navigation: Experience of a Brazilian oncology network.
Authors: Leal Jorge Henrique Santos , Santoro Ricardo Silva , Coelho Anderson Jose Morais , Marques Mariana Cantarino , Batista Ninive Miranda , Landeiro Luciana , Cardoso Carolina da Silva , Pascual Bianca Pinna , Laloni Mariana 
Published: October 2023

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Background: Cancer treatment involves the use of long-term therapies, mostly oral, and new drug developments are improving patients’ survival, bringing hope, but also more complexity to care delivered. Trials using digital platforms for patient remote monitoring demonstrated increased survival and patient satisfaction, but demands a great effort in implementation and multidisciplinary team engagement. Oncoclínicas Group is a large multidisciplinary private oncology network present in 35 Brazilian cities with 133 units that have specialists in the areas of oncology, radiotherapy, hematology and bone marrow transplantation, multidisciplinary teams, complementary care and the most advanced in integrated assistance and individualized treatment. Here we describe our experience in developing and implementing the platform OC por Você. Methods: In July 2022, Oncoclinicas Group partnered with Meu Médico startup to develop an EHR-integrated platform that was adherent to Oncoclínicas safety needs. The agile development process incorporated user-centered design principles that required engagement from patients, clinicians, and health care systems. Defined features: a chat center specifically designed for the patient and multidisciplinary team with decision tree for patients specifics needs; embedded telemedicine; digital prescription; sending images or documents; view of the patient chart, health professionals agenda, pathology test results; access to treatment protocols for each cancer type. In January 2023 a first wave was planned, implementing in three sites. From April through June 2023, seven waves of implementation were planned. The Oncoclínicas Digital Team trained all health professionals before launch, and educational videos and digital cards were developed for both health professionals and patients. Results: From January through April 2023, 149 users downloaded the mobile platform. There were 11 doctors, 44 non-medical health professionals and 94 patients. A total of 199 chats were initiated, with 3409 messages exchanged and 20 teleconsultations. From April through June 2023, the platform was implemented in a total of 21 units, 10 cites, where 990 users downloaded the mobile platform. There were 173 doctors, 318 non-medical health professionals and 499 patients. A total of 870 chats were initiated, with messages exchanged and 224 teleconsultations. Until December 2025 other waves of implementation will happen to complete the full implementation process. Conclusions: Implementing a digital mobile platform for cancer patient care is feasible in a private oncology practice network in Brazil. Several pitfalls were identified, especially the need for constant engagement with the care provider team. Systems of this nature should be encouraged in order to keep the communication channel open to patients and families, improving the care to be rendered.