Telehealth in Multidisciplinary Target Delineation for Radiotherapy During the COVID-19 Pandemic. A Review and a Case

Abstract

Like all other medical specialities, radiotherapy has been deeply influenced by the COVID-19 pandemic. The pandemic has had severe influence on the entire patient trajectory in oncology, from diagnosis to treatment and follow-up. Many examples of how to deal with patient and staff safety, shortness of staff and other resources and the quest to continue high-quality, evidence-based treatment have been presented. The use of telemedicine and telehealth is frequently presented as a part of the solution to overcome these challenges. Some of the available presented solutions will only apply in an acute, local setting, whereas others might inspire the community to improve quality and cost-effectiveness of radiotherapy as well as knowledge sharing in the future. Some of the unresolved issues in many of the available technical solutions are related to data security and public regulation, e.g., GDPR (General Data Protection Regulation) in the EU and HIPAA compliance (Health Insurance Portability and Accountability Act) in the USA. Using a solution that involves a supplier's server in a non-EU country is problematic within the EU. In this paper we shortly review the influence of COVID-19 on radiotherapy. We describe some of the possible solutions for telehealth in target delineation – a crucial part of high-quality radiotherapy, which often requires multidisciplinary effort, hands-on corporation, and high-quality multimodal imaging. Hereafter, our own technical solution will be presented as a case.

Covid-19 and radiotherapy: a systematic review after 2 years of pandemic

“…Thirteen studies recommended the use of telemedicine [ 22 , 27 , 29 , 30 , 33 , 36 , 40 , 42 , 44 , 50 – 53 ].…”

“…There is a very similar scenario with regards to the digitization of the healthcare system [ 22 , 51 , 53 , 308 , 309 ].…”

Current status of remote radiotherapy treatment planning in Japan: findings from a national survey

“…Although there exist scattered references [ 18–20 ] demonstrating the utility of remote diagnosis for patients undergoing radiation therapy planning and case reviews via video conferencing [ 13 , 21 ], there are few reports on the use of detailed remote radiotherapy treatment planning (RRTP) or surveys on their actual utilization. This investigation introduces the current situation in Japan by classifying its use into four categories of RRTP.…”

Impact of COVID-19 on older adults with cancer and their caregivers’ cancer treatment experiences study: The ICE-OLD study

“…As the pandemic stretched on, the use of telehealth applications such as email, virtual conferencing, and mobile applications utilized in oncology garnered considerable interest [28][29][30][31][32]. Personal experiences and preferences of cancer patients and clinicians has also been increasingly examined [33][34][35][36][37][38][39]. Previous qualitative studies conducted during the pandemic highlighted positive experiences such as increased frequency of patient-clinician interactions, improved workflow and job satisfaction, convenience, and access to medical professionals [40][41][42][43][44].…”