Roles and Key Responsibilities of ONSITE Teleoncology Personnel

ONNs

Review patient records.
Contact the patient within one business day.
Educate patients about the telenavigation and teleoncology process.
Assess and address barriers to care.
Review referral and patient information with the medical oncologist.
Determine appointment time, based on when additional studies will be completed, if needed.
Contact the patient and educate them about any additional workup needed and appointment date and time.
Contact onsite clinic nurse and inform them about the plan of care, additional workup, appointment date and time, and any other relevant information.
Update the referring provider about the plan of care.
Send the patient written documentation outlining the next steps, appointment date and time, and other relevant information.
Follow up with the patient at each proactive navigation touchpoint.
Educate the patient about systemic therapy when the treatment plan is established.
Educate the patient about the survivorship care plan when treatment is complete.
Serve as a point of contact for the patient, family, and oncology team.
Communicate all appropriate aspects of care to the clinic nurse.

Clerical staff

Receive patient referrals from onsite clinical staff.
Register the patient in the electronic health record (EHR) system and upload the referral.
Notify ONN about the referral.
Request any needed patient records.
Propose additional EHR orders as directed by the ONN or oncologist.
Schedule patient appointments.
Preauthorize treatment regimens.

Clinic or infusion nurses

Meet the patient for their appointment.
Conduct the nursing assessment.
Complete a physical assessment as directed.
Double check with the pharmacy providing the treatment medications.
Communicate all appropriate aspects of care with the ONN.

Seemingly overnight, many patients went from viewing telehealth as an intimidating frontier to embracing it with gusto. Fortunately, health care has prepared for years to put the infrastructure and people in place to support telehealth expansion.

One emerging new role, particularly in the oncology field, is telenavigation. In their article in a special telehealth supplement to the June 2020 issue of the Clinical Journal of Oncology Nursing, Rowett and Christensen outlined the collaborative role of the oncology nurse navigator (ONN) in providing virtual cancer care through telehealth.

Teleoncology Care

Just like telehealth visits with other healthcare providers, teleoncology uses video- and audioconferencing and phone calls to provide care for patients with cancer. Some of the benefits for oncology, Rowett and Christensen reported, include addressing the predicted shortage of oncologists combined with the aging population as well as reducing geographic cancer disparities. It’s a collaborative service that involves all members of the interprofessional cancer care team: oncologists, nurses, and support staff (e.g., financial advocates, social workers, schedulers).

Teleoncology is used for genetic counseling, access to clinical trials, symptom management, and survivorship care. It also offers oncology nurses and other healthcare providers the opportunity to address many of the physical, economic, and psychosocial barriers to care that patients may experience. However, managing the complexities of cancer care at a distance requires significant care coordination, and ONNs are finding a new role in the field of teleoncology care.

Telenavigation and ONNs

ONNs’ key responsibilities include improving care coordination, supporting provider communication, addressing patients’ logistical challenges, providing patient and family education, delivering survivorship care, and addressing other barriers that patients with limited oncology access face—all of which can be done through telehealth, Rowett and Christensen explained. When part of the teleoncology care team, ONNs facilitate care transitions; identify and address barriers to care; support patients’ physical, psychosocial, and spiritual needs; and serve as a single point of contact for patients, families, and the interprofessional team.

They also work closely with clinic and infusion center nurses when patients do need in-person treatment. Together, they identify patient needs, reiterate patient education, and connect patients to nearby healthcare services.

What This Means for Oncology Nurses

As technology and telehealth continue to expand in practice, nurses will see new roles emerge and have more opportunities to collaborate. In their institution’s pilot program, Rowett and Christensen found that having clear role delineation was critical to successful telenavigation. Incorporating that into a structured process prevents multiple people working on the same task and inefficient duplication of work.

According to the authors, telehealth offers patients and providers the opportunity for high-touch, supportive, patient-centered care throughout the cancer continuum. Patients report that ONNs helped them navigate use of the new technology in addition to the cancer experience. They also identified value in having all members of the cancer care team, including point-of-care nurses, advise them on reliable apps and information sources for their cancer and treatment.

For more information about the role of ONNs and other oncology nurses in telehealth and the opportunity to earn 0.5 contact hours of NCPD, free for ONS members, refer to the full article by Rowett and Christensen and the entire Clinical Journal of Oncology Nursing supplement.

Topics: