# Balancing ideals and realities: health care professionals’ perspectives of and attitudes toward digital patient-centered cancer care

## TL;DR

This study explores how healthcare professionals in Norway view digital tools for patient-centered cancer care, highlighting the need for workflow alignment and cultural shifts to successfully integrate these tools into routine cancer treatment.

## Contribution

The study provides new insights into healthcare professionals' perspectives on digital patient-centered care in oncology, emphasizing the need for workflow integration and cultural adaptation.

## Key findings

- Healthcare professionals see digital PROMs as promising for patient-centered care but stress the need for workflow alignment and stakeholder engagement.
- Digital literacy, workload implications, and overreliance on PROMs are key concerns among healthcare professionals.
- Successful integration of patient-centered care requires organizational and cultural adaptations alongside digital tool implementation.

## Abstract

Patient-centered care (PCC) improves quality of life, symptom management and healthcare outcomes in oncology. However, integration into routine cancer care remains limited. Digital solutions using patient-reported outcome measures (PROMs) offer a potential mechanism to operationalize PCC. This study explored healthcare professionals’ (HCPs) pre-implementation perspectives on using digital PROMs to support PCC in Norwegian oncology outpatient clinics, informing the design and implementation strategies of the European MyPath digital solution.

Semi-structured interviews (n = 29) and three focus groups (n = 16) were conducted with varied HCPs across four Norwegian hospitals. Interviews explored perceptions of PCC, experiences with PROMs, and requirements for digital implementation. Data were analyzed using thematic analysis, combining inductive and deductive coding guided by the TPOM framework.

Four themes emerged: (1) balancing PCC with disease-centered practices, (2) integrating PCC into daily routines, (3) customization and patient acceptance of digital tools, and (4) combining patient-reported data with clinical autonomy. HCPs viewed digital PROMs as promising for facilitating PCC but emphasized that successful implementation requires workflow alignment, adaptable digital solutions, and strong stakeholder engagement. Concerns included patient digital literacy, workload implications, and overreliance on PROMs at the expense of direct patient interaction.

Our findings highlight a tension between HCPs’ needs for technical functionality and workflow alignment, and the support required to adapt their practice to fully realize PCC through digital tools. Integrating PCC successfully requires organizational, cultural, and workflow adaptations, alongside active HCP engagement in design and implementation. These changes are essential to reposition PCC as an integral rather than competing component of high-quality cancer care.

The online version contains supplementary material available at 10.1007/s11136-025-04103-w.

Cancer treatment often focuses primarily on treating the tumor, while the emotional, physical, and psychological impacts on patients are overlooked. These factors can significantly affect patients' quality of life during and after treatment. The study addresses the challenge of integrating patient-centered care into cancer treatment, an approach that considers patients' overall well-being, not just their cancer. This study is part of the European Union-funded project MyPath, that aims to develop a digital tool supporting more patient-centered cancer care in Europe. Understanding the perspectives of healthcare providers is essential in ensuring that the tool fits with real-world clinical settings. The main point of this study is to explore how healthcare providers view patient-centered care and the role of digital tools in improving quality of life through better symptom management. The results show that healthcare providers recognize the importance of enhancing quality of life and believe that digital tools could support a more patient-centered approach to care. However, they tend to view patient-centered care as more relevant to end-of-life or palliative care, rather than active cancer treatment. This suggests that while digital tools hold potential to improve quality of life, a shift in mindset and hospital cultures is needed to make patient-centered care an equal part of cancer treatment, rather than a competing focus.

The online version contains supplementary material available at 10.1007/s11136-025-04103-w.