Telehealth in cancer care during the COVID-19 pandemic

Abstract

Introduction The Victorian COVID-19 Cancer Network (VCCN) Telehealth Expert Working Group aimed to evaluate the telehealth (TH) experience for cancer patients, carers and clinicians with the rapid uptake of TH in early 2020 during the COVID-19 pandemic. Methods We conducted a prospective multi-centre cross-sectional survey involving eight Victorian regional and metropolitan cancer services and three consumer advocacy groups. Patients or their carers and clinicians who had TH consultations between 1 July 2020 and 31 December 2020 were invited to participate in patient and clinician surveys, respectively. These surveys were opened from September to December 2020. Results The acceptability of TH via both video (82.9%) and phone (70.4%) were high though acceptability appeared to decrease in older phone TH users. Video was associated with higher satisfaction compared to phone (87.1% vs 79.7%) even though phone was more commonly used. Various themes from the qualitative surveys highlighted barriers and enablers to rapid TH implementation. Discussion The high TH acceptability supports this as a safe and effective strategy for continued care and should persist beyond the pandemic environment, where patient preferences are considered and clinically appropriate. Ongoing support to health services for infrastructure and resources, as well as expansion of reimbursement eligibility criteria for patients and health professionals, including allied health and nursing, are crucial for sustainability.

Telehealth follow‐up consultations for melanoma patients during the COVID‐19 pandemic: Patient and clinician satisfaction

“…Clinicians and patients were congruent in expressing convenience, safety and improved access to care as benefits of telehealth, consistent with previously reported research 18,20,23,41 . Patients also reported that telehealth allowed family and friends to be present in a supportive role during the consultation, without a major impact on the family member/friend's routines.…”

“…Rapid transition to telehealth resulting from COVID‐19 44 may not have allowed sufficient time to source adequate technology and provide appropriate training for both clinicians and patients, which may also explain why the majority of telehealth consultations in this study were conducted via telephone rather than audio‐visually. Additionally, both patients and clinicians perceived telehealth communication to be less personal and more difficult due to reduced availability of non‐verbal cues, consistent with the findings from other cancer groups 12,14,23,39,41 . Good interpersonal communication and rapport are especially important when symptoms and emotional issues are discussed, 21,40 and have been shown to be improved by the inclusion of an audio‐visual medium 19,41 …”

“…Additionally, both patients and clinicians perceived telehealth communication to be less personal and more difficult due to reduced availability of non-verbal cues, consistent with the findings from other cancer groups. 12,14,23,39,41 Good interpersonal communication and rapport are especially important when symptoms and emotional issues are discussed, 21,40 and have been shown to be improved by the inclusion of an audio-visual medium. 19,41 Clinicians and patients were congruent in expressing convenience, safety and improved access to care as benefits of telehealth, consistent with previously reported research.…”

Consumers’ experiences, preferences, and perceptions of effectiveness in using telehealth for cancer care in Australia

“…Across cancer care, telehealth has been employed in services such as outpatients, pre‐therapy surgical reviews, monitoring, chemotherapy, and clinical trials 6–9 . Telehealth has successfully ensured the continuation of cancer care, particularly for those people living in rural or regional areas, where specialist services are limited 10,11 …”

“…[6][7][8][9] Telehealth has successfully ensured the continuation of cancer care, particularly for those people living in rural or regional areas, where specialist services are limited. 10,11 The long-term sustainability of telehealth depends on a number of key requirements, including empowering consumers to confidently seek and engage in telehealth. 12 As end-users, consumers have a unique perspective regarding their treatment and whether it complies with their expectations of care.…”