Virtual Cancer Care During the COVID-19 Pandemic and Beyond: A Call for Evaluation.

Oren Hannun Levine,Mark Levine,Michael Mcgillion

doi:10.2196/24222

Abstract

The interplay of virtual care and cancer care in the context of the COVID-19 pandemic is unique and unprecedented. Patients with cancer are at increased risk of SARS-CoV-2 infection and have worse outcomes than patients with COVID-19 who do not have cancer. Virtual care has been introduced quickly and extemporaneously in cancer treatment centers worldwide to maintain COVID-19–free zones. The outbreak of COVID-19 in a cancer center could have devastating consequences. The virtual care intervention that was first used in our cancer center, as well as many others, was a landline telephone in an office or clinic that connected a clinician with a patient. There is a lack of virtual care evaluation from the perspectives of patients and oncology health care providers. A number of factors for assessing oncology care delivered through a virtual care intervention have been described, including patient rapport, frailty, delicate conversations, team-based care, resident education, patient safety, technical effectiveness, privacy, operational effectiveness, and resource utilization. These factors are organized according to the National Quality Forum framework for the assessment of telehealth in oncology. This includes the following 4 domains of assessing outcomes: experience, access to care, effectiveness, and financial impact or cost. In terms of virtual care and oncology, the pandemic has opened the door to change. The lessons learned during the initial period of the pandemic have given rise to opportunities for the evolution of long-term virtual care. The opportunity to evaluate and improve virtual care should be seized upon.

Highlights

The COVID-19 pandemic has catapulted virtual care into the forefront of oncology practice [1,2,3,4,5,6,7]
The introduction of virtual care during the onset of the pandemic was an emergency strategy for maintaining cancer centers as COVID-19–free zones to avoid any potential interruption in treatments
Virtual care is defined as an interaction between clinicians and patients that occurs remotely through http://cancer.jmir.org/2020/2/e24222/

Summary

Introduction

The COVID-19 pandemic has catapulted virtual care into the forefront of oncology practice [1,2,3,4,5,6,7]. The introduction of virtual care during the onset of the pandemic was an emergency strategy for maintaining cancer centers as COVID-19–free zones to avoid any potential interruption in treatments. In this commentary, virtual care is defined as an interaction between clinicians and patients that occurs remotely through http://cancer.jmir.org/2020/2/e24222/. The parameters of video-based communication can limit direct eye contact and leave room for miscommunication and the indeterminacy of one’s intent [24] It remains unclear whether visits scheduled for potentially sensitive conversations should be done virtually or in person. If patients perceive a lack of access to cancer centers when urgent in-person assessments are needed, they may resort to visiting the emergency department for symptom complaints or treatment toxicity. Administrative data should be scrutinized to assess the impact of virtual care on acute care resource utilization [35]

Conclusion

29. Virtual Care