Digital native doctors

Three junior doctors at the Chris O’Brien Lifehouse have taken their careers in a new direction, and might just help a lot of cancer patients in the process

URBAN Dictionary, the online resource for all things pop culture, defines a digital native as “someone born just before, during or after the general introduction of digital technologies and, through interacting with digital technology from an early age, has a greater understanding of its concepts”.

Three junior doctors from the Chris O’Brien Lifehouse in Sydney are walking, talking, healing and thinking models of the digital native, and they’re putting that greater understanding to fantastic use.

Dr Nikhil Pooviah, Dr Raghav Murali-Ganesh and Dr Akshat Saxena are in their late 20s and are all Lifehouse trainees — Nik and Raghav in radiation oncology, and Akshat in cardiothoracic surgery.

They have developed a smartphone app called CancerAid, which they have been working on for the past 19 months and which will officially launch in June of this year.

“It’s a digital health solution to improve cancer care, not just in Australia, but also globally,” Nik told the MJA.

CancerAid is designed to help patients receiving a cancer diagnosis to digest and understand the information they’re given about their tumour and treatment at their own pace.

“It’s user driven so, the patient will sit with their clinician at the initial appointment. [Using simple dropdown menus, the clinician inputs personalised information for the patient] — this is your cancer, this is the staging of it, these are the treatment options we recommend for it, and this is what you can expect to come, and why,” Nik said.

“Then the patient can go home and, at their own pace, digest that information. It’s kind of like a gold standard resource.”

But there’s a second, and perhaps more revolutionary component to CancerAid.

“The second way [to use the app] is by integrating through existing hospital software,” Raghav said.

“For example, chemotherapy and radiotherapy require multiple appointments over several months. [At the moment] a patient’s information has to be printed out and any time there is a change, it has to be printed out again. It’s a very manual transaction.

“But now with our app, by integrating it into the system, you create out a level where it’s all digital and it’s all real-time information. If there are any changes, we can let the patient know immediately … all their journey, all their information is integrated through the app.

“Cancer care like every other kind of health care is very fragmented. By approaching patient groups, peak body organisations [and] governments, we’ve been able to address the viewpoint of all the key players in health care delivery.

“Getting their viewpoint and approval and support from each and every one allows one product to be made, and that one product addresses the problems of each of those sectors.

“Therefore that fragmentation can be offset by addressing the needs of every one of those groups.

“It’s like a patient manager. It allows the patient to hold on to their own healthcare.”

There is a research potential to CancerAid as well, the trio believes.

“We have a captive group of patients and caregivers. One of the biggest things affecting cancer patients is quality of life outcomes and with the app you can assess that at various intervals — 3 months, 6 months — through an electronic survey that’s sent out through the app, rather than phone calls or questionnaires through the mail,” Akshat said.

So why did three junior doctors, working through the maze of internships, registration training and long shifts decide to turn their careers in a different direction?

“Medicine is a very conservative society,” Raghav says.

“We’ve actually felt barriers to entry [to this aspect of our careers] from our peers, perhaps because by choosing an alternative route that’s not the proscribed pathway, we’re not validating what their career choices might be.

“That sometimes is a bit difficult for a conservative society to accept, because the norm is to do your registration training, get your fellowship, go overseas, come back, set up your rooms as a junior consultant and then progress through that pathway.

“And I think sometimes medical practitioners find that [different pathway] quite difficult to digest.”

Akshat said he couldn’t resist the idea of making a difference on a large scale.

“You have a career that is stable and pays well, and it’s very hard for people to look outside that. But, to me, this inherently warrants further investigation and further innovation.

“This is an opportunity to really improve the quality of life of patients. Without innovation you won’t be able to do that.”

Nik told the MJA that helping other doctors break into the innovation side of medicine was a long-term goal.

“Health professionals will have the best ideas for innovation, but because of time commitments, lack of resources, a lot of them won’t pursue a lot of these avenues.

“Hopefully, if we’re successful we can inspire others to. We want to help nurture other healthcare professionals. If you’ve got a great idea, come to us, we’ve got the experience, we’ll give you the resources, we’ll give you the tech team, and you can be in charge of the business as much as you want.”

Nik and Raghav are working fulltime on making sure CancerAid is ready and fully funded before its launch in June. Akshat still has 5 months of his training to complete but also hopes to spend more time on health innovation.

“I do love clinical medicine but I really want to make this a success,” he said.

Raghav wants to stay hands on with patients — “patient contact is why I got into medicine” — but “I love this side of things because it allows me to explore a side that’s actually untapped. There’s so much potential”.

Nik is wholeheartedly devoted to his new career path.

“I’d like to be doing this fulltime, the app, I love it. This is like a hobby, it doesn’t feel like work and I don’t want to shift back.

“Instead of just helping one patient now I have the opportunity to help quite a large number very quickly.”

Signs are encouraging for CancerAid, with over 100 cancer specialists providing input to both the content and design.

Patients are also enthusiastic, including 50-year-old Dominique Morency, who has the rare cancer leiomyosarcoma.

“CancerAid is easy to use and will mean I can just listen to my doctor rather than frantically taking notes during appointments,” she said. “I use technology to simplify every other aspect of my life. I should be able to do the same with my cancer.”

Clinical Associate Professor Kerwyn Foo, radiation oncologist at the University of Sydney, hopes the app will overcome the desperate shortage of personalised cancer information available to patients.

“One of CancerAid’s greatest strengths is its involvement of the patient’s clinical team to ensure the information is both personalised and accurate,” he said.

Professor Jon Emery, professor of Primary Care Cancer Research at the University of Melbourne, said CancerAid was “an exciting development” that could significantly improve information-sharing between health care providers.