The National Cancer Institute has awarded the Sidney Kimmel Cancer Center – Jefferson Health a supplemental grant to study the role of telehealth in delivering cancer care during the COVID-19 pandemic.
The National Cancer Institute (NCI) has awarded the Sidney Kimmel Cancer Center – Jefferson Health (SKCC) a supplemental grant (P30) to study the role of telehealth in delivering cancer care during the COVID-19 pandemic. The project will evaluate the impact of telehealth on health outcomes, patient and clinician well-being, and health equity.
In order to increase safety measures for patients and staff, SKCC expanded the availability of telehealth to ensure continuity of care for a patient population who faces an increased risk of serious complications from COVID-19 infection. These virtual appointments include new patient consultations to discuss care plans, follow-up visits when medically appropriate, multidisciplinary visits, and virtual visits with the oncology social work team.
SKCC first implemented telehealth as part of a cancer care strategy in 2017. These efforts served as the foundation to allow the center to rapidly scale telehealth activities, thus reducing risk, exposure, and assuring continuity of care, according to the grant’s director, Ana María López, MD, MPH, MACP, Professor and Vice Chair of Medical Oncology at SKCC and Chief of Cancer Services for SKCC – New Jersey.
From Jan. 1 through March 15, 2020, there were 456 telehealth visits completed across SKCC in medical, surgical, and radiation oncology. During the pandemic between March 16 and June 7, 7,952 telehealth visits were completed across SKCC.
A previous pilot study of surgical oncology patients at SKCC found that post-operative telehealth visits reduced readmissions and emergency department visits while improving patient satisfaction. The researchers plan to extend these findings and further assess the impact of telehealth on these outcomes by tracking and comparing the pre-telehealth expansion prior to the pandemic, mid-pandemic telehealth expansion, and post-telehealth expansion post-pandemic.
Patients and caregivers often experience psychosocial distress and anxiety related to a cancer diagnosis, which has heightened in the backdrop of the pandemic. SKCC had already implemented screening for patient distress; the researchers will compare the screening results of patients who had telehealth appointments with those who had in-person visits to determine whether telehealth decreased distress among patients and their caregivers by providing access to comprehensive care at home.
In addition, the researchers will be conducting a novel assessment of distress among the clinical teams. Health care professionals are experiencing increased stress and anxiety in response to the general uncertainty of the pandemic, as well as the added challenges of providing care during this unprecedented time, Lopez explained. By facilitating access to care, telehealth may help alleviate health professional distress.
Telehealth requires digital access, yet many patients at SKCC lack routine internet access or report having low digital literacy. To support health equity in telehealth care and address social factors proactively, SKCC established a Telehealth Task Force. The task force addresses access barriers to telehealth, considers patients’ health literacy and language, and troubleshoots technical difficulties. The research team will assess the impact of this task force and expand effective strategies that promote health equity in cancer care.
The SKCC telehealth research team will also meet regularly with the two other U.S. institutes that were awarded P30 supplement funding dedicated to understanding cancer patient management through telehealth during the COVID-19 national emergency. “The synergy and partnership with Stephenson Cancer Center at the University of Oklahoma and Dartmouth-Hitchcock Norris Cotton Cancer Center gives the projects the potential to impact telehealth cancer care nationwide,” Lopez said.
“Each cancer center serves a different patient population. The centers’ collaboration will provide an opportunity to compare and analyze the impact of telehealth on ethnically and socioeconomically diverse populations in different geographic settings. We are thankful that the NCI recognized the fundamental importance of determining how telehealth has impacted cancer care across a wide demographic—toward the purpose of refinement and increasing access,” said Karen E. Knudsen, MBA, PhD, EVP of Oncology Services and Enterprise Director of SKCC.