Practical guidance for telemedicine use in neuro-oncology

Abstract

While the COVID-19 pandemic has catalyzed the expansion of telemedicine into nearly every specialty of medicine, few articles have summarized current practices and recommendations for integrating virtual care in the practice of neuro-oncology. This article identifies current telemedicine practice, provides practical guidance for conducting telemedicine visits, and generates recommendations for integrating virtual care into neuro-oncology practice. Practical aspects of telemedicine are summarized including when to use and not use telemedicine, how to conduct a virtual visit, who to include in the virtual encounter, unique aspects of telehealth in neuro-oncology, and emerging innovations.

Telemedicine in Neuro-Oncology—An Evaluation of Remote Consultations during the COVID-19 Pandemic

“…One of the main incentives to implement telemedicine has traditionally been to provide adequate medical service for people in remote communities [ 4 ]. Even in densely populated areas, specialists for neuro-oncology are still rare, and patients have to expect a long travel time [ 16 ]. Consequently, we also observed that patients with long travel distances predominately participated in VC and had fewer consultations in total.…”

“…Patients and caregivers experienced various types of visits with different requirements during neuro-oncological treatment. In their practice guideline, Strowd, et al [ 16 ] provided an overview of encounters that they considered more or less suitable for telemedicine on general considerations. Our survey participants mostly agreed with their judgement that the monitoring and initiation of chemotherapy and remote surveillance visits after MRI control present highly suitable encounters for VC, as well as second opinion encounters and consultations about clinical trials.…”

“…Since then, we have experienced the opportunities and limitations of telemedicine in neuro-oncology. Though two large treatment facilities have reported some exciting experiences with VC in neuro-oncology [ 15 ] and experts of the neuro-oncology section of the American Academy of Neurology published a detailed guide on telemedicine [ 16 ], the currently published reports are mainly based on the experience of experts, a preliminary data basis or primarily focused on pediatric neuro-oncology [ 17 , 18 , 19 , 20 , 21 , 22 ]. To the best of our knowledge, a more detailed evaluation of VC in neuro-oncology has not been provided so far.…”

Digital Health for Oncological Care

“…Certain conditions or populations may have special needs that create demand for bespoke telemedicine options. For example, many patients who require subspecialty oncology visits must travel long distances to access services such as neuro-oncology 32 . This is frequently further complicated by comorbid neurological disability that makes physical travel even more burdensome and creates a telemedicine opportunity for initial and follow-up telemedicine-based visits.…”

“…For example, many patients who require subspecialty oncology visits must travel long distances to access services such as neuro-oncology. 32 This is frequently further complicated by comorbid neurological disability that makes physical travel even more burdensome and creates a telemedicine opportunity for initial and follow-up telemedicinebased visits. Telemedicine offerings may be tailored to other specific patient care and clinical supportive services needs such as with speech, swallowing, and nutrition after head and neck cancer treatment.…”