The uptake of telehealth by both patients and health professionals during COVID-19 presents a unique opportunity to reform the future care of people with cancer and many other health conditions.
Published last month in the Internal Medical Journal (IMJ), ‘Telehealth in cancer care: during and beyond the COVID‐19 pandemic‘ provides expert guidance for the routine application of telehealth as a model of optimal and integrated cancer care. More importantly, the paper’s authors identify and discuss benefits, and address some proposed challenges and solutions associated with telehealth.
The article’s expert overview of existing data, technology, health centre strategies and current utilisation was an outcome of the Victorian COVID-19 Cancer Network (VCCN) Telehealth Expert Group, led by Associate Professor Zee Wan Wong, Head of Oncology at Peninsula Health and Clinical Director of the Southern Melbourne Integrated Cancer Service.
“Every crisis presents us with opportunities, and the rapid adoption of telehealth across cancer care services is one that we carry forward beyond the pandemic,” said Associate Professor Wong.
“Extensive institutional experience across this group demonstrated that both health professionals and people with cancer found telehealth accessible, efficient and suitable for delivering high quality care,” said Dr Craig Underhill, Medical Oncologist at Albury Wodonga Health and a member of the VCCN Taskforce.
“Telehealth is a care model with many benefits both obvious and subtle, including reduced travel time and lesser social disruption in patients’ lives,” Dr Underhill added.
Associate Professor Kate Burbury, Consultant Haematologist at the Peter MacCallum Cancer Centre and a member of the VCCN Taskforce, observed:
“This article is intended as a practical guide for the effective implementation of telehealth in routine cancer care during and beyond the COVID-19 pandemic, to overcome access and quality differences imposed by geographical and social restrictions.”
Importantly, ongoing funding for telehealth through the Medical Benefits Scheme is essential for the continuation of this model of care. Delivering high quality care to areas with limited internet and/or phone services, and to people who have limited technological proficiency, is also a high priority.
Vulnerable groups including the elderly, patients with disabilities, people from culturally and linguistically diverse backgrounds and those with low health literacy are a future area for future strategies supporting the telehealth model.
“The practical resources and suggestions in this article extend to care delivery at the tumour stream level. Importantly, many of the perceived barriers have been addressed with practical and care-enhancing solutions,” Dr Craig Underhill said.
“For example, when a physical examination is required, we suggest conducting a consultation with the patient in the office of a primary carer such as GP and/or practice nurse. This is something we have been doing with some remote patients and there is high user acceptance. GPs generally see it as a great learning experience and opportunity to share care,” Dr Underhill added.
Telehealth technology offers flexible and efficient care, but systems must be fit for purpose and have adequate infrastructure, including IT and administrative support, if they are to be used in a sustainable, routine and successful way. Reliable equipment that works well, is compatible with patients and their treating teams, and facilitates an accurate transfer of information is vitally important.
“Although architectural challenges, to date, have limited the routine application of telehealth in cancer care, with strong collaboration across the health sector and partnerships between providers and the community, I believe a high quality statewide system can be implemented,” said Dr Underhill.