Telemedicine for Outpatient Neurosurgical Oncology Care: Lessons Learned for the Future During the COVID-19 Pandemic

Abstract

BACKGROUND: The coronavirus 2019 (COVD-19) pandemic has drastically disrupted the delivery of neurosurgical care, especially for the already at-risk neuro-oncology population. The sudden change to clinic visits has rapidly spurned the implementation of telemedicine. A recommendation care paradigm of neuro-oncologic patients limited by telemedicine has not been reported.-METHODS: A summary of a multi-institution experience detailing the potential benefits, pitfalls, and the necessary considerations to outpatient care of neurosurgical oncology patients.-RESULTS: There are limitations and advantages to incorporating telemedicine into the outpatient care of neuro-oncology patients. Telemedicine-specific considerations for each step and stakeholder of the appointment (physician, patient, scheduling, previsit, imaging, and physical examination) are examined.-CONCLUSIONS: Telemedicine, pushed to prominence during this COVID-19 pandemic, is a powerful and possibly preferential tool for the future of outpatient neurooncologic care.

Doctor-patient distancing: an early experience of telemedicine for postoperative neurosurgical care in the time of COVID-19

“…One of the disadvantages that we faced in our study is the inability of some surgeons to perform accurate remote clinical examinations especially motor power assessment in some spinal cases. In the future, we might support modern technologies which would enable us to perform satisfying remote examination [ 14 ].…”

E-mental health mindfulness-based and skills-based ‘CoPE It’ intervention to reduce psychological distress in times of COVID-19: study protocol for a bicentre longitudinal study

“…14 15 Various eHealth approaches from different medical fields have already been implemented into medical care during the COVID-19 pandemic. [16][17][18] They offer great advantages in terms of patient-professional communication and provide timely symptom management. Rehabilitation programmes which support patients with the SARS-CoV-2 virus in maintaining their physical fitness during individual quarantine have been reported by one centre in Japan.…”

“…16 A multi-institutional study investigating potential benefits and pitfalls of telemedicine in outpatient neuro-oncological care during COVID-19 showed that telemedicine is a powerful and possibly preferable tool for the future. 17 Moreover, different clinics in the USA reported a reduction in medical visits per day in primary care practices, due to the use of virtual practices. 18 Furthermore, patients from those clinics had an almost universally positive response to those changes.…”

An Asian Perspective of the Management of COVID-19: the Asian National Cancer Centers Alliance Led Regional Comparison

“…Going forward, further application of technologies, for instance digital imaging, remote medication supply, the use of machine learning and artificial intelligence for autonomous robot for examination, and the use of virtual reality environment for training and education purposes are transformational windows of opportunity for safer oncology care and training delivery [40]. Virtual care delivery should be appropriately documented to facilitate billing [41]. National health coverage and commercial medical insurance should reconsider to revise their payment policy and provide reimbursement for telemedicine activities in response to pandemic [42].…”