Teleoncology Addresses Health Disparities With High Satisfaction for Patients and Providers, NCI Shares
Virtual appointments and other telehealth care allow patients and families to have ready access to cancer care from the comfort of their own home, Kevin M. Curtis, MD, medical director of the Center for Telehealth at Dartmouth-Hitchcock Health, said (https://www.cancer.gov/news-events/cancer-currents-blog/2022/pandemic-telehealth-surge-cancer-care) in a March 2022 National Cancer Institute (NCI) blog post praising the service. Curtis also highlighted telehealth’s role in addressing health disparities, its high satisfaction rate with both patients and clinicians, and the service’s future in cancer care research.
Curtis wrote that prior to the pandemic, his center was averaging 8 scheduled outpatient telehealth visits a day. However, at the pandemic’s first peak in April 2020, that number increased (https://www.liebertpub.com/doi/abs/10.1089/tmj.2020.0468) to more than 2,600 visits in a single day.
Today, “probably somewhere in the ballpark of about 12% of outpatient oncology visits are done by telehealth,” Curtis said of his institution. NCI’s blog post also reported (https://aacrjournals.org/clincancerres/article/27/4/933/124880/Optimizing-the-Use-of-Telemedicine-in-Oncology) that 40% of patient visits at the University of Texas at San Antonio Mays Cancer Center occurred by telehealth in August 2020 and cited additional research that indicated (https://aacrjournals.org/clincancerres/article/27/4/933/124880/Optimizing-the-Use-of-Telemedicine-in-Oncology) that Sidney Kimmel Comprehensive Cancer Center at Jefferson Health in Philadelphia saw nearly 7,000 patients via telehealth from March–July 2020, compared with approximately 150 patients during the same period in 2019.
The data showcase a widespread rise in telehealth use at NCI-designated cancer centers, and NCI said (https://www.cancer.gov/news-events/cancer-currents-blog/2022/pandemic-telehealth-surge-cancer-care) the increase can be explained in part to temporary policy measures (https://telehealth.hhs.gov/providers/policy-changes-during-the-covid-19-public-health-emergency) during the public health emergency; however, the service’s positive outcomes have cemented it as a lasting offering for patients at any stage of the cancer journey.
According to NCI and additional research (https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.15_suppl.1579), patients with cancer report high satisfaction with their telehealth visits, and clinicians and other members of the interprofessional care team also report generally high satisfaction. However, in-person visits were preferable for promoting a patient-provider connection.
“In an office setting, the physician is thinking about the next patient. Whereas on the telehealth visit, you feel like it’s just you and the physician and you have their undivided attention,” Larry Starling, a patient undergoing treatment for male breast cancer, said (https://www.cancer.gov/news-events/cancer-currents-blog/2022/pandemic-telehealth-surge-cancer-care) in the blog post. “The technology is to the point where you almost feel like you’re in the office with him. I didn’t lose any feeling of being connected, talking to him over the telehealth visit.”
As use of telehealth rises, so does the need for healthcare professionals to address its related health disparities.
“Amid the increasing demand for telehealth, experts worry that some populations that could potentially benefit the most from telehealth—including older adults and those living in rural areas—may be left behind,” NCI said (https://www.cancer.gov/news-events/cancer-currents-blog/2022/pandemic-telehealth-surge-cancer-care). “Others include people from low-income groups and racial/ethnic minority groups, and those for whom English is not their first language.”
“Telehealth has the potential to address disparities. Because marginalized populations can struggle disproportionately with issues like transportation barriers, time away from work, and competing demands for caregiving, telehealth can really ameliorate a lot of those demands,” Urmimala Sarkar, MD, associate director of the University of California, San Francisco, Center for Vulnerable Populations, said (https://www.cancer.gov/news-events/cancer-currents-blog/2022/pandemic-telehealth-surge-cancer-care) in the blog post.
Researchers are investigating ways to expand telehealth’s use, including the ability to monitor a patient’s symptoms remotely via mobile phones and other devices and exploring new technologies like artificial intelligence and virtual reality to expand telehealth’s limits.
“Telehealth is here to stay,” Debra L. Friedman, MD, associate director for Community Science and Health Outcomes at Vanderbilt Ingram Cancer Center, said (https://www.cancer.gov/news-events/cancer-currents-blog/2022/pandemic-telehealth-surge-cancer-care) in the blog post. “We just have to continue to work on making it more available and simpler for people to use.”