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.
Development of a telehealth geriatric assessment model in response to the COVID-19 pandemic
J Geriatr Oncol. 2020 ;11(5):761-763.
Telehealth in geriatric oncology: A novel approach to deliver multidisciplinary care for older adults with cancer
J Geriatr Oncol. 2020 ;11(2):197-199.
Optimizing Telehealth for Older Adult Patients with Cancer
ASCO Daily News. Oct. 22, 2020.
Assessing Telemedicine Unreadiness Among Older Adults in the United States During the COVID-19 Pandemic
JAMA Intern Med. 2020;180(10):1389-1391.
Telehealth in older adults with cancer in the United States: The emerging use of wearable sensors
J Geriatr Oncol. 2017 ;8(6):437-442.
How to Provide Telehealth to Older Adults.
American Psychological Association. August 13, 2020.
The Urgent Need for Rigorous Studies of Telehealth for Older Adults Who Are Homebound
JAMA Netw Open. 2021;4(9):e2113451.
Perceptions of Telehealth vs In-Person Visits Among Older Adults With Advanced Kidney Disease, Care Partners, and Clinicians
JAMA Netw Open. 2021;4(12):e2137193.
4 Strategies to Make Telehealth Work for Elderly Patients
Harvard Business Review. Nov 24, 2020.
Overcoming Telehealth Barriers and Engaging Older Adults in Virtual Care
Telehealth in cancer care during COVID-19: disparities by age, race/ethnicity, and residential status
J Cancer Surviv. 2021.
Telehealth for older adults should include family caregivers, study says
Becker’s Hospital Review. Jan 25, 2022.
Video series to improve digital literacy – Patient Empowerment Network
Encourage your patients to view these easy-to-follow video modules to become more digitally savvy. Online healthcare resources can further help patients aid and empower their cancer journey.
Genetic counselors—as members of the cancer care team—can help patients better understand their cancer diagnosis, make informed treatment decisions, and navigate the financial costs of testing.
Gain insights into how the City of Hope’s advanced practice-led geriatric consult clinic—which provides a holistic approach to geriatric oncology based on ASCO and NCCN guidelines—developed a telehealth assessment tool geared toward the unique needs of older adults.
Experts provide practical strategies to gather critical information quickly and effectively about your patients’ functional health, whether by phone or video. Learn proven methods to perform these assessments on adults with cancer—even when they are not in your physical office.
This panel of supportive care specialists will share practical tips on the use of psychosocial screening tools and how to effectively integrate them into your practice. In honor of Breast Cancer Awareness Month, a case study will highlight the journey of a patient with metastatic breast cancer.