The growing use of telecommunication and technology to provide health care – or telemedicine – offers many advantages, but also comes with challenges, says one expert.
The growing use of telecommunication and technology to provide health care — or telemedicine – offers many advantages, particularly by allowing patients to report on their symptoms earlier in treatment, thus possibly preventing hospitalization and other adverse outcomes.
But with these benefits come with challenges as well — ones that Jennie Crews, of the Seattle Cancer Care Alliance and the Association of Community Cancer Centers (ACCC), recently spoke with CURE about at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting.
In particular, she discussed how telemedicine is currently being used in oncology, how it impacts outcomes in some patients with cancer and what roadblocks it currently faces in being implemented on a broader scale.
CURE: Can you start by talking about telemedicine in the cancer space in general?
Crews: Telemedicine in oncology has a lot of opportunity. I think we’re behind some of the other specialties in implementing telehealth as a tool for delivering care, primary care has been using this for quite some time but there are pockets of best practices where practices and cancer programs have been incorporating telehealth. There’s huge opportunity around not only provider-to-provider education, which I think oncologists have had more experience in the realm of telehealth doing teleconferencing and that type of provider-to-provider education.
Where we haven’t used it as much is in patient-facing telehealth visits, or virtual visits. Now we’re also beginning to explore remote patient monitoring with some of the data that has come out with patient-reported outcomes showing improved survivorship for many patients.
So, we’re beginning to see the advantages of telehealth, and there are more and more practices that are interested in implementing telehealth.
Can you expand a bit more on the patient-reported outcomes you mention?
We’ve heard at this ASCO meeting in the past couple of years about improvements in outcomes of lung cancer patients and other oncology patients who have been able to report proactively their symptoms so that interventions can be taken earlier and avoid hospitalizations and other adverse outcomes, so we’re really beginning to understand the importance of (patient-reported outcomes).
What are some ways that telemedicine can be incorporated with the use of immuno-oncology in the community?
We just tackled this question with a working group and met in May at our (Immunotherapy) Summit, that was jointly sponsored by ACCC and SITC (Society for Immunotherapy of Cancer), and interestingly I think there are several main areas where we might be able to employ telehealth to help in (immunotherapy): one is in education, the other is in regulatory issues, and finally in demonstrating cost effectiveness.
Around education, we know that we’re facing challenges of bringing providers together to understand how to best use these drugs, how to manage toxicities, and telehealth may provide a platform to do that effectively. If we can identify centers of excellence that could be the hubs of knowledge and then we could connect other cancer programs via the spoke of telehealth, we can help disseminate that information more effectively.
There’s a lot of opportunity around regulatory advocacy, and this is an area that ACCC focuses on. We know that not all forms of telehealth are reimbursed. We know that there are some challenges state to state, with what is paid for via telehealth. So, we can have opportunities both at the national and state levels to advocate for reimbursement for this way of delivering healthcare.