Research Article| Volume 51, ISSUE 4, P551-557, March 2015

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Internet-based technologies to improve cancer care coordination: Current use and attitudes among cancer patients

Published:February 04, 2015DOI:



      The uses of internet-based technologies (e.g. patient portals, websites and applications) by cancer patients could be strong drive for change in cancer care coordination practices. The goal of this study was to assess the current utilisation of internet-based technologies (IBT) among cancer patients, and their willingness to use them for their health, as well as analyse the influence of socio-demographics on both aspects.


      A questionnaire-based survey was conducted in June 2013, over seven non-consecutive days within seven outpatient departments of Gustave Roussy, a comprehensive cancer centre (≈160,000 consultations yearly), located just outside Paris. We computed descriptive statistics and performed correlation analysis to investigate patients’ usage and attitudes in correspondence with age, gender, socioeconomic status, social isolation, and place of living. We then conducted multinomial logistic regressions using R.


      The participation level was 85% (n = 1371). The median age was 53.4. 71% used a mobile phone everyday and 93% had access to Internet from home. Age and socioeconomic status were negatively associated with the use of IBT (p < 0.001). Regarding patients’ expected benefits, a wide majority valued its use in health care, and especially, the possibility to enhance communication with providers. 84% of patients reported feeling comfortable with the use of such technologies but age and socioeconomic status had a significant influence.


      Most patients used IBTs every day. Overall, patients advocated for an extended use of IBT in oncology. Differences in perceived ease of use corresponding to age and socioeconomic status have to be addressed.


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      1. ASCO Report: The state of Cancer Care in America; 2014.

        • Kelly R.J.
        • Smith T.J.
        Delivering maximum clinical benefit at an affordable price: engaging stakeholders in cancer care.
        Lancet Oncol. Mar. 2014; 15: e112-e118
        • Clauser S.B.
        • Wagner E.H.
        • Aiello Bowles E.J.
        • Tuzzio L.
        • Greene S.M.
        Improving modern cancer care through information technology.
        Am J Prev Med. 2011; 40: S198-S207
      2. Gorin SS, Haggstrom D, Fairfield K, Han P, Krebs P, Clauser SB. Cancer care coordination systematic review and meta-analysis: Twenty-two years of empirical studies. In: ASCO annual meeting; 2013.

        • Bodenheimer T.
        • Wagner E.H.
        • Grumbach K.
        Improving primary care for patients with chronic illness.
        JAMA. Oct. 2002; 288: 1775-1779
        • Lewis R.A.
        • Neal R.D.
        • Hendry M.
        • France B.
        • Williams N.H.
        • Russell D.
        • et al.
        Patients’ and healthcare professionals’ views of cancer follow-up: systematic review.
        Br J Gen Pract. 2009; 59: e248-e259
        • Atherton H.
        • Sawmynaden P.
        • Sheikh A.
        • Majeed A.
        • Car J.
        Email for clinical communication between patients/caregivers and healthcare professionals.
        Cochrane Library. 2012; 11 ([Review])
      3. Eurostat, Accès et Utilisation d’internet en 2013; 2013.

        • Chou W.S.
        • Liu B.
        • Post S.
        • Hesse B.
        Health-related Internet use among cancer survivors: data from the Health Information National Trends Survey, 2003–2008.
        J Cancer Surviv. 2011; 5: 263-270
        • Baker L.
        • Wagner T.H.
        • Singer S.
        • Bundorf M.K.
        Use of the internet and E-mail for health care information.
        J Am Med Assoc. 2003; 289
        • Davis F.D.
        Perceived usefulness, perceived ease of use, and user acceptance of information technology.
        Manage Inf Syst. 2010; 13 ([Management Information Systems Research Center, University of Minnesota]): 319-340
        • Eysenbach G.
        The impact of the Internet on cancer outcomes.
        CA Cancer J Clin. 2003; 53: 356-371
        • Helft P.R.
        • Eckles R.E.
        • Johnson-Calley C.S.
        • Daugherty C.K.
        Use of the internet to obtain cancer information among cancer patients at an urban county hospital.
        J Clin Oncol. 2005; 23: 4954-4962
        • Bartlett Y.K.
        • Selby D.L.
        • Newsham A.
        • Keding A.
        • Forman D.
        • Brown J.
        • et al.
        Developing a useful, user-friendly website for cancer patient follow-up: users’ perspectives on ease of access and usefulness.
        Eur J Cancer Care. 2012; 21: 747-757
        • Castleton K.
        • Fong T.
        • Wang-Gillam A.
        • Waqar M.A.
        • Jeffe D.B.
        • Kehlenbrink L.
        • et al.
        A survey of Internet utilization among patients with cancer.
        Support Care Cancer. 2011; 19: 1183-1190
        • Kruse R.L.
        • Koopman R.J.
        • Wakefield B.J.
        • Wakefield D.S.
        • Keplinger L.E.
        • Canfield S.M.
        • et al.
        Internet use by primary care patients: where is the digital divide?.
        Fam Med. 2012; 44: 342-347
        • Or C.K.L.
        • Karsh B.-T.
        A systematic review of patient acceptance of consumer health information technology.
        JAMIA. 2009; 16: 550-560
        • Kwok R.
        Phoning in data.
        Nature. 2009; 458: 959-961
      4. Rapport Credoc, La diffusion des technologies de l’information et de la communication dans la société française; 2013.

        • Ross S.E.
        • Lin C.-T.
        The effects of promoting patient access to medical records: a review.
        JAMIA. 2003; 10: 129-139
        • Turley M.
        • Garrido T.
        • Lowenthal A.
        • Zhou Y.Y.
        Association between personal health record enrollment and patient loyalty.
        Am J Managed Care. 2012; 18: e248-e253
        • Coiera E.
        Social networks, social media, and social diseases.
        BMJ. 2013; 346: 3007
        • Topol E.
        The creative destruction of medicine: how the digital revolution will create better health care.
        Basic Book. 2012; : 303
        • Hall J.L.
        • McGraw D.
        For telehealth to succeed, privacy and security risks must be identified and addressed.
        Health Affairs (Project Hope). Feb. 2014; 33: 216-221
        • Protière C.
        • Moumjid N.
        • Bouhnik A.-D.
        • Le Corroller Soriano A.G.
        • Moatti J.P.
        Heterogeneity of cancer patient information-seeking behaviors.
        Med Decis Making. 2011; 32: 362-375
        • Minvielle E.
        • Waelli M.
        • Sicotte C.
        • Kimberly J.R.
        Managing customization in health care: A framework derived from the services sector literature.
        Health Policy (Amsterdam, Netherlands). 2014;
        • Zhou Y.Y.
        • Kanter M.H.
        • Wang J.J.
        • Garrido T.
        Improved quality at Kaiser Permanente through e-mail between physicians and patients.
        Health Affairs (Project Hope). Jul. 2010; 29: 1370-1375
        • Basch E.M.
        • Thaler H.T.
        • Shi W.
        • Yakren S.
        • Schrag D.
        Use of information resources by patients with cancer and their companions.
        Cancer. Jun. 2004; 100: 2476-2483
        • Rose P.W.
        • Watson E.
        What is the value of routine follow-up after diagnosis and treatment of cancer?.
        Br J Gen Pract. 2009; : 482-483
        • Cappiello M.
        • Cunningham R.S.
        • Knobf M.T.
        • Erdos D.
        Breast cancer survivors: information and support after treatment.
        Clin Nurs Res. 2007; 16 ([discussion 294–301]): 278-293
        • Schwamm L.H.
        Telehealth: seven strategies to successfully implement disruptive technology and transform health care.
        Health Affairs (Project Hope). Feb. 2014; 33: 200-206
        • Banerjee A.K.
        • Ingate S.
        Web-based patient-reported outcomes in drug safety and risk management.
        Drug Saf. 2012; 6: 437-447
        • Paulhus D.L.
        Measurement and control of response bias.
        in: Wrightsman L. Robinson J. Shaver P. Measures of personality and social psychological attitudes. Academic Press, 1991: 17-59