Digital Bridges: Optimizing Telehealth for Older Adults with Cancer

Before the onset of COVID-19, telehealth was a rarely used mode of healthcare delivery. Laws and regulations were not friendly to telehealth; restrictive interstate licensing rules and poor reimbursement effectively meant it was rarely an option for most patients. Much of that changed in early 2020, when the country shut down seemingly overnight in response to COVID-19. By April 2020, outpatient care and clinician office visits via telehealth were 78 times higher than in February 2020. As of July 2021, telehealth use had stabilized at 38 times higher than before the pandemic. Today, more than two years into the waxing and waning of COVID-19, utilization now ranges between 13 percent to 17 percent across all specialties.

The swift and widespread adoption of telehealth in community oncology during the COVID-19 pandemic presented care teams with considerable challenges—and silver linings. On one hand, care teams lost some personal connection with patients—you can’t give a hug over the phone. On the other hand, telehealth minimized patients’ and providers’ exposure to COVID-19 and reduced travel burdens on patients and their families. Moreover, telehealth and other supportive technologies have expanded access to quality cancer care for patients and provided a glimpse into the patient’s home environment, allowing care teams to assess their need for supportive services.

According to findings from a series of focus groups conducted by ACCC in late 2020, community cancer centers are using telehealth and other supportive technologies to remain engaged with their most vulnerable patients during the pandemic. As COVID-19 continues to hamper efforts to support the physical return of many patients to their providers, oncology providers need practical strategies to maintain high-quality cancer care virtually. This is particularly true for older adult patients, who make up approximately 70% of cancer patients in the community setting and are at high risk of toxicity and other adverse events associated with anti-cancer therapies.

During this project, ACCC will interview geriatric oncology experts about how to conduct geriatric assessments via telehealth and how to better assist older adults and their caregivers in effectively engaging with virtual healthcare services. In addition, an educational webinar series will give participants the opportunity to learn more about providing cancer care to older adults via telehealth. Leaders in geriatric oncology will provide tips on how to best conduct assessments of patients’ physical functions and how to assess patients’ psychosocial health virtually, in addition to sharing other successful models of geriatric screening and assessment through telehealth.