Telehealth Ushering in a New Era in Cancer Care
New Technology Allows More Cost-Efficient Care Delivery
Significant advances in remote monitoring and virtual care have been observed, noted Ms Adzhigirey. For example, clinicians have moved from text-based programs to mobile apps that can automatically collect and transmit accurate, in-the-moment vital signs. “Innovations in wearables, from ingestible to patches, are making it even easier to monitor symptoms, vital signs, and all sorts of personal health data. And we are seeing important benefits, including earlier detection and intervention, improved quality of life for patients, a reduction in hospital readmissions and unnecessary ED visits, and improved data accuracy,” said Ms Adzhigirey.
Blue tooth technology now enables 24-hour blood pressure monitoring and better monitoring of body temperature. “It is all about monitoring patients better and not allowing them to reach a situation where they need urgent care,” said Dr Dicker. “I think it can lower morbidity and mortality, and as practices incorporate these technologies, there can be a video check-in. Running a list of questions and answering the questions patients may have, you can use the in-person time more effectively if you use telehealth.”
Jennie R. Crews, MD, medical director of the affiliate network program and of research integration for Seattle Cancer Care Alliance (SCCA) in Seattle, Washington, said telehealth is helping to make sure your zip code does not keep you from getting tier-one cancer care. There are now a number of mobile apps to help patients track their pain, nausea, and other associated complications between doctor visits. Some apps are designed to help improve pain control and reduce hospital utilization by addressing barriers to pain management. In some cases, patients can receive daily pain management tips as well as prompts to regularly track their pain levels. “Telehealth provides a great solution to leveling that playing field,” said Dr Crews. “Oncology is facing a shortage of providers. We probably don’t have an adequate supply of new oncologists replacing the workforce. It is a supply and demand issue. Baby boomers are demanding more services and there are a higher number of them.”
Dr Crews envisions telehealth becoming the new standard of care for patients with metastatic cancer. Pita M. Nims, RN, senior clinical program manager and telehospitalist at Providence St Joseph Health in Seattle, Washington, and co-chair of the ATA Nursing SIG, said she is seeing an increased interest and adoption of telehealth, which she attributes to a number of factors. “First, it’s no secret that we are facing a critical shortage of health care providers, while our society’s burgeoning aging population is requiring more and more medical care. The traditional in-person care delivery model will not hold up under this burden,” said Ms Nims.
Using emerging technologies, remote patient monitoring, and virtual care solutions, clinicians can effectively scale the existing best practice care models to address this growing need. In addition, telehealth helps to reduce the cost of healthcare and increase efficiencies. “Telehealth technology extends the reach of the specialist into those communities where, historically none have been available,” explained Ms Nims. “Whether it’s providing clinical expertise in partnership with local physicians or directly to the patient in either a clinic or home setting, telemedicine has the power to remove barriers regardless of where you live.”
Great progress has been made on the reimbursement front, and as a result, the telehealth market is growing rapidly. “A recent survey by American Well found that physician adoption of telehealth increased 340% between 2015 and 2018. While this is impressive growth, we have a lot more work to do to make telehealth a standard of care across the health care ecosystem,” said Ms Nims.
1. Cheville AL, Moynihan T, Herrin J, Loprinzi C, Kroenke K. Effect of collaborative telerehabilitation on functional impairment and pain among patients with advanced-stage cancer: a randomized clinical trial. JAMA Oncol. 2019; 5(5):644-652.