With advances in surgical techniques and adjuncts, and increasing adjuvant therapy options, there have been dramatic improvements in the care of brain tumor patients over the past two decades. With extended survival and reduction of gross neurological morbidity, measures of treatment success have appropriately shifted to more patient-centred metrics, including healthrelated quality of life (HRQOL). We have developed the world’s largest dataset on HRQOL in brain tumours, comprising more than a thousand patients, with multiple sub-studies arising from it. Our findings include prolonged reductions in HRQOL over many years, even in “cured” patients, and an understanding of the chief determinants of reduced HRQOL, particularly fatigue, sleep disturbance, perceived cognitive deficit, anxiety/depression and future uncertainty. Additionally, our investigation of brain tumour patients’ use of social media find them to be a socially and often geographically isolated population for whom distinct solutions for supportive care and to improve HRQOL will be necessary. Innovative imaging and machine learning methods to predict those patients most vulnerable will be important, allowing targeting of scarce supportive care interventions where they are most needed. Lastly, the development of an innovative digital platform to improve outcomes in a resource efficient fashion will be described.