Opportunities and challenges in implementing digital patient-centred cancer care in Europe-a qualitative study of...

Patient-centred care (PCC) improves patient outcomes in cancer care, such as survival and quality of life, yet it remains inconsistently implemented across Europe due to system- and provider-level barriers that favour disease-centred models. Guided by expert perspectives from the ESMO Designated Centres (DCs), the European Union-funded MyPath project is developing a digital solution incorporating patient-reported outcome measures to operationalise PCC across diverse European contexts. This study aims to explore challenges and opportunities for implementing digital solutions to enhance PCC in oncology, ensuring relevance and scalability across Europe using insights from ESMO DCs.

A qualitative study was conducted through three semistructured focus groups with 21 clinicians and leaders from 14 ESMO DCs across 14 European countries. Qualitative analysis, guided by the Technology, People, Organisations, and Macroenvironment (TPOM) framework, identified multilevel implementation factors.

The analysis identified three main themes: (i) Challenges in adapting a digital PCC solution across diverse health care settings, where heterogeneity in health care organisation, resources, and political systems challenges universal implementation; (ii) The complexity of providing PCC in digital formats, highlighting the tension between standardised and flexible care; and (iii) The need for training and cultural shifts to support successful implementation, describing the need to adjust clinical behaviours and workflows to foster PCC.

Effective digital PCC depends not only on technical integration and clinical training but also on adaptability to different care settings, infrastructures, and professional cultures. This study highlights the conditions for scalable implementation of digital PCC across Europe, offering practical implications for health system leaders and policymakers.