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Telehealth

Advances in communications technology are continuing to affect all aspects of society. Healthcare is no exception. From electronic health records to patient portals and virtual tumor boards, integration of telehealth and telemedicine into healthcare is increasing.

Examples of telehealth and telemedicine utilization include, but are not limited to, videoconferences, audio conferences, electronic transmission of digital images, e-health applications, patient portals, remote patient monitoring, a variety of virtual healthcare provider training options, continuing medical education, nursing call centers, and more.

Although there is no standard definition of telehealth, current consensus is that telehealth is the broader, overarching term. Telehealth encompasses all forms of remote healthcare services, both clinical and non-clinical.

According to the American Telemedicine Association (ATA), "the term [telehealth] itself can evoke a limited view of what telehealth does. What was, until recently, referred to as telemedicine now encompasses a much broader array of services and technologies – AI, virtual reality and behavioral economics are a few examples that come to mind. . . . "1

While the potential of telehealth and telemedicine has been recognized for decades, the COVID-19 public health emergency (PHE) created an imperative that—at least temporarily—removed many long-standing barriers to broader adoption of telehealth solutions.2 Previous to the COVID-19 pandemic, often-cited barriers to wider integration of telehealth approaches included significant regulatory and reimbursement barriers, cost concerns, variability in state-level policies and requirements, and anticipated provider and patient resistance to adoption of this new care delivery approach.3

With the loosening of restrictions and policies to allow rapid implementation of telehealth during the COVID-19 pandemic, health systems, hospitals, cancer programs, and practices have demonstrated the viability of telehealth and telemedicine for some aspects of cancer care.

Adoption and Expansion of Telehealth Solutions

This educational initiative addresses the immediate and ongoing needs of cancer programs and practices that want to implement, integrate, and expand their telehealth services to optimize patient care and aims to educate the multidisciplinary cancer team on how to optimize telehealth.

Digital Bridges: Optimizing Telehealth for Older Adults with Cancer

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.

Health Information Technology

As healthcare transitions to a patient-centric, value-based model, the role of information technology (IT) has become critical for data collection and reporting, for supporting patient engagement and education, for providing point-of-care information for providers, and more.

Featured Resource: Telehealth in Action

ACCC documented successes in the cancer care community’s rapid adoption of telehealth to maintain patient care during the COVID-19 public health emergency. To obtain multiple perspectives on best practices in team-based telehealth delivery, ACCC conducted multidisciplinary focus groups with three member sites.

ACCC also conducted interviews with oncology professionals across the country—including a financial advocate, an information technology (IT) professional, a nurse, an oncologist, a pharmacist, and social workers—to learn how their roles were impacted by—and adapted to—the growing need for telehealth services since the onset of the pandemic.
EXPERIENCE TELEHEALTH IN ACTION

Podcasts

On-Demand Webinars

From Oncology Issues

  • Remote Patient Monitoring and Health Equity
    By David R. Penberthy, MD, MBA
    Amid the implementation of technological solutions such as remote patient monitoring in cancer care, it is important that all patients with cancer—regardless of race, ethnicity, and socio-economic status—benefit equitably.
  • AI's Role in Advancing Cancer Prevention Detection Diagnosis Treatment and Precision Medicine
    Amanda Patton, MA
    An interview with Picture Health’s Anant Madabhushi, PhD, and Trishan Arul on the expanding role of AI and healthcare professionals in the fields of biomedical engineering and computer science.
  • ePROs: Lighting the Way to Improved Outcomes Efficiency and Patient Experience
    Amanda Patton, MA
    Highlands Oncology Group took key steps toward implementing an ePRO platform aimed at reducing emergency department utilization and unplanned hospitalization, while improving the patient’s quality of life.
  • Changing the Tune for CAR T-Cell Therapy
    Brittney M. Baer, BSN, RN, and Nancy C. Long, MSN, AGACNP-BC
    Remote patient monitoring can eliminate the need for the hospitalization of patients dealing with the toxicities of CAR T-Cell Therapy, thereby improving the overall patient experience and aiding cancer programs cut costs.
  • Spotlight: Logan Health, Logan Health Cancer Program, Kalispell, Montana
    An article spotlighting Logan Health, Logan Health Cancer Program, Kalispell, Montana.
  • Remote Patient Monitoring: The New Frontier in Telemedicine Opportunities
    Ksenia Gorbenko, Alaina Kessler, Mark Liu, Melanie Besculides, Carol Kisswany, Madhu Mazumdar, and Cardinale B. Smith
    Physician shortages and growing healthcare costs threaten the sustainability of the in-person care model, but telemedicine and remote monitoring can be solutions for delivering equitable cancer care and improving access to quality care.
  • Spotlight: Coastal Cancer Center, Myrtle Beach, South Carolina
  • Coping with COVID-19 in Patients with Lung Cancer
    Elizabeth S. Ver Hoeve, Sarah N. Price, Tara K. Torres, Heidi A. Hamann, and Linda L. Garland
    This study examined the coping strategies and psychosocial well-being of patients with lung cancer facing multiple stressors, primarily due to the COVID-19 pandemic.
  • Delivering Hospital Level Acute Care at Home Learning from Huntsman at Home
    By Amanda Patton
    This program delivers intensive hospital-level care to eligible patients in their own homes through a care team that includes oncology nurse practitioners, home health registered nurses, and allied healthcare staff.
  • Home as a Site of Care for Acutely Ill Patients with Cancer
    By Amanda Patton
    An interview with Kathi Mooney, PhD, RN, FAAN, about the Huntsman at Home model, including the development and implementation of Symptom Care at Home.
  • The Home as a New Site of Cancer Care
    By David R Penberthy, MD, MBA
    The COVID-19 pandemic brought renewed attention to the concept of the home being a site of care. Looking to the future, certain strategies can be implemented for cancer programs aiming to offer care to patients in their homes.
  • Technology Solutions in Practice
    By Sibel Blau, MD
    The successful deployment of technology in cancer practices, promises to improve the quality of patient care and the patient experience, while also alleviating excessive burdens on clinicians and staff.
  • Tech Solutions Ahead!
    By David R. Penberthy, MD, MBA
    Technology-drive solutions will be essential in the future of cancer care, and providing the information, education and resources health care providers need to implement those solutions is important.
  • Time to Get Screened
    By Amanda Patton
    The COVID-19 pandemic has had a negative impact in the rate of cancer screening across various states in the United States. Louisiana, Delaware, Kentucky and Northern Michigan serve as vehicles for an analysis of the disparity in cancer screening rates, before and after the pandemic.
  • Remote Home Monitoring of Patients with Cancer During the COVID 19 Pandemic
    By Mary Steimer, et al.
    The COVID-19 pandemic has created a necessity for the incorporation of remote home monitoring for cancer patients, in order to maintain the health of both the patient and the health care workers who aid them.
  • A Model Telehealth Adolescent and Young Adult Oncology Program
    By Amanda Parkes, MD, et al.
    The overall cancer rate among adolescents and young adults is on a gradual increase, thus creating the need for oncology programs geared towards young adults and adolescents.
  • Congress Extends Access to Telehealth and Funds Cancer Research
    By Matt Devino, MPH
    A $1.5 trillion omnibus spending package for fiscal year 2022 was passed with broad bipartisan support in Congress and signed into law by President Biden on March 15, 2022.
  • Development of a Virtual Integrative Oncology Center
    Alissa Huston, MD
    Because of the COVID-19 pandemic, Wilmot Cancer Institute's integrative oncology team shares how integrative oncology-based services can be delivered via telehealth.
  • 3-D Virtual Reality Takes Patient Education to the Next Level
    Douglas E. Holt, MD
    In 2019, at the University of Colorado, Douglas Holt, MD, led the effort to implement and study the use of virtual reality within the clinic for patient education in oncology.
  • Views: A Pandemic's Silver Lining: Building a Collaborative Integrative Therapy Program
    Brenda A. Biggerstaff, MSW
    To meet patients’ needs during the height of the pandemic, this cancer program created a collaborative and more efficient hybrid-style Integrative Therapy Program for all of its oncology sites.
  • Rapid Practice Change During COVID-19 Leads to Enduring Innovations and Expansion of Integrative Oncology Services
    Danielle Gentile, PhD, et al.
    This cancer program continues to meet patients’ psychosocial needs through enduring telehealth expansion, livestream groups and classes, and on-demand digital repositories.
  • Compliance: Telehealth After the Public Health Emergency
    Teri Bedard, BA, RT(R)(T), CPC
    Though the current public health emergency (PHE) is anticipated to be extended through the end of 2021 by Health and Human Services Secretary Xavier Becerra, the fate of telehealth after the PHE remains a concern for providers.
  • Trending Now in Cancer Care
    Alexandria Howson, PhD
    Rather than fielding its annual Trending Now in Cancer Care survey while cancer programs were experiencing unprecedented challenges due to the extended public health emergency, ACCC chose to facilitate conversations with its members to capture the lived experiences of the most pertinent issues impacting oncology practice and care delivery.
  • Community Oncology Can Close the Gap in Cancer Research
    Amanda Patton, MA
    This is the story of how a large independent practice in northwest Arkansas has nurtured its research program over several decades and is now able to offer patients access to phase I, II, and III trials close to home and their families.
  • Key Areas of Interest Going Into 2021
    Randall A. Oyer, MD
    With the enormous pressures of COVID-19, the ever-increasing complexity of oncology care, and the persistent social factors that lead to medical injustice, it is difficult to think about tackling even one more job. Yet, we must, we can, and we do. Today I want to mention four specific areas that all cancer programs need to be watching, thinking about, and preparing for.
  • Compliance: What Telehealth May Look Like in 2021
    Teri Bedard, BA, RT(R)(T), CPC
    The 2021 Medicare Physician Fee Schedule proposed the following changes specific to telehealth.
  • Genetic Cancer Screening and Testing in a Medically Underserved Community
    Erica Martinez, RN, CHPN, OCN
    Genetic screening and testing are paving the way for improved patient care and outcomes on a broad scale that encompasses both cancer treatment and prevention. Access to this testing is key to identifying and thereby reducing disease burden, suffering, and cost.
  • Virtual Infusion Services: Bringing Cancer Therapies Closer to Rural Patients
    Susan Halbritter, CNP, MSN, AOCN, ANP-BC, et al.
    Although many rural facilities in South Dakota do have infusion centers that administer anti-cancer therapies, these centers are generally not directly overseen by an oncologist or oncology trained advanced practice provider. Rather, local family practice or internal medicine physicians who are often unfamiliar with oncologic therapies oversee the administration of infusions.
  • Virtual Care After Treatment: How Telemedicine Can Expand Survivorship Programs
    Holly Bushart, MSN, ACNP-BC, AOCNP, et al.
    Though the importance of post-cancer care is widely acknowledged, cancer programs and practices continue to struggle with the optimal approach for conducting dedicated survivorship visits. As a result, many patients still go without survivorship care. Telemedicine—which has increased access to care in numerous specialties—may offer one solution to these challenges

Telehealth Resources

  • Telemedicine and Cancer Care: Today’s Learnings for a Post-Pandemic World
    Nov 20, 2020

    Envision a day that cancer clinicians can ask an app to advise on immuno-oncology (IO) treatment options for a patient. That day may not be far off.

  • Virtual Navigation to Clinical Trials
    Jan 4, 2019

    In the current oncology clinical trials landscape, many barriers remain to clinical trial enrollment that affect both the oncologist and the patient. Among these are trial locations, strict eligibility requirements, insufficient resources to support appropriate clinical trial education and screening, as well as patient and provider attitudes about trials.

  • Telehealth: Partner in Innovation
    Nov 12, 2018
    The paradigm-changing advancements accompanying immunotherapy for cancer continue to require innovation in care delivery. Telehealth is a natural innovation partner for immuno-oncology when applied to patient-reported outcomes, provider education, and clinical trial enrollment. 

From the ACCCBuzz Blog

References

  1. American Telemedicine Association. Telehealth Basics. https://www.americantelemed.org/resource/why-telemedicine. Accessed July 1, 2020.
  2. Centers for Medicare & Medicaid Services. Additional background: sweeping regulatory changes to help U.S. healthcare system address COVID-19 patient surge. https://www.cms.gov/newsroom/fact-sheets/additional-backgroundsweeping-regulatory-changes-help-us-healthcare-system-address-covid-19-patient. Accessed July 1, 2020.
  3. Sirintrapun JS, et al. Telemedicine in Cancer Care. American Society of Clinical Oncology Educational Book 38 (May 23, 2018) 540-545. https://ascopubs.org/doi/full/10.1200/EDBK_200141. Accessed July 1, 2020.