Document Type
Article
Abstract
Background: Although three-fourths of cancer deaths are expected to occur in low- and middle-income countries (LMICs) by 2030, most cancer research still comes from high-income countries. One barrier to cancer research in LMICs is lack of infrastructure for systematic data collection, including electronic medical record systems. We developed Treatment Outcome Monitor (TOM), a cloud-based tool for tracking cancer patient outcomes, designed specifically for resource-limited settings.
Methods: TOM was developed through iterative design cycles with continuous feedback from health care providers from across the world. We focused on creating a simple, web-based solution that addresses real-world challenges in resource-limited settings. The platform includes questionnaire creation, patient data tracking, and automated patient communication via text or email. We created detailed user instructions for 9 core tasks and conducted usability testing. Six health care professionals (4 radiation oncologists, 1 oncology surgeon, and 1 medical physicist) completed all tasks and rated their confidence and ease of use on a 5-point Likert scale (1 = lowest, 5 = highest).
Results: During development, end users identified critical requirements that shaped the platform. Key features included cloud-based architecture to eliminate local IT infrastructure needs, printable questionnaires for offline use during internet outages, patient messaging to address poor clinic follow-up rates, and integration of standardized patient-reported outcome measures. The platform achieved high usability scores. Five users (83%) rated all tasks as 4 or 5 for both confidence and ease of use. One user gave lower ratings for some tasks (ratings of 3). Overall, 92% of all responses (99 of 108 total ratings across all users and tasks) scored 4 or 5, indicating high usability.
Conclusions: We successfully developed a user-friendly, cloud-based platform for cancer outcome monitoring and data collection in resource-limited settings. Through collaborative design with end users, TOM addresses practical barriers including limited IT infrastructure, unreliable internet, and poor patient follow-up. The high usability scores demonstrate that thoughtful, user-centered design can create tools that are both technically sound and appropriate for resource-limited contexts. By simplifying systematic data collection, TOM may help enable clinics in LMICs to participate more fully in cancer research.
Grants and Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Nair S, Alarcon A, Barrios M, Cabrera M, Villeda M, Steyn J, Richards A, Ruggeri R, Orozco L, Velarde A, Mallick I, Lazarus G, Trauernicht C, de Falla V, Edwards T, Inthaphone J, Olanrewaju A, Court LE, Niedzielski J. TOM: Treatment Outcome Monitor - A Web-Based Tool Designed Specifically for Clinics With Limited Resources. Advances in Cancer Education and Quality Improvement. 2026; 2(1).