The risks associated with the widespread use of telemedicine in oncology: Four cases and review of the literature

Panet, François; Tétreault-Langlois, Marianne; Morin, Vincent; Sultanem, Khalil; Melnychuk, David; Panasci, Lawrence

doi:10.1002/cnr2.1531

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…With this in mind, it is important for practices to properly document that medical advice and diagnoses were given on the lack of a physical exam, as previous literature has shown medical complications and medicolegal concerns of physicians in other specialties. 18,19 However, given the ease, acceptance, and cost-effectiveness of telemedicine and VCs in surgical practices, 20 it will likely be a fixture in practices for the foreseeable future. 10…”

Section: Discussionmentioning

confidence: 99%

Utilization of Virtual Consultations in Facial Plastic Surgery during the COVID-19 Pandemic

et al. 2022

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Background The coronavirus disease 2019 pandemic affected many aspects of medical practice, particularly surgical fields. The American College of Surgery initially recommended the cancellation of all elective procedures. As a result, virtual consultations (VCs; a form of telemedicine), became widely used in the field of facial plastic and reconstructive surgery. With more facial plastic and reconstructive surgeons (FPRS) conducting both in-person and virtual visits, it is imperative to understand how VCs are utilized in practice. Methods An electronic, anonymous survey was distributed to 1,282 electronic mail addresses in the 2018 American Academy of Facial Plastic and Reconstructive Surgery directory. The survey collected responses on various topics including demographic information and past, current, and future use of VCs. Results The survey yielded 84 responses. Most surgeons (66.7%) were 11+ years out of fellowship. There was a significant increase in the percentage of VCs scheduled after the pandemic than before (p = 0.03). FPRS most frequently responded that VCs should always be followed by an in-person visit (48.6%). A majority of FPRS (66.2%) believe that VCs have improved the delivery of health care in at least some cases. Almost all FPRS (86.5%) plan on using VCs after the pandemic. Conclusion Since the pandemic, VCs are more frequently used by surgeons and are mostly utilized as an initial patient visit. A majority of FPRS believe that VCs have improved health care in at least some cases, and plan on using VCs after the pandemic.

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Section: Discussionmentioning

confidence: 99%

Utilization of Virtual Consultations in Facial Plastic Surgery during the COVID-19 Pandemic

et al. 2022

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The risks associated with the widespread use of telemedicine in oncology: Four cases and review of the literature

et al. 2021

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Background: COVID-19 changed the way we practice oncology in multiple ways.Because most cancer patients are comorbid or immunocompromised, we are trying as much as possible to reduce their risk of infection. Marginal just 2 years ago, telemedicine quickly became preeminent with the pandemic to reduce hospital exposure.However, using only virtual visits in oncology patients risk delaying cancer diagnosis or the identification of a complication. Case series:We present here four cases where a serious medical problem evident on physical exam was overlooked during a virtual visit. Two of our patients experienced a delay in cancer diagnosis thus putting them at risk of local or distant spread. The two others were established oncology patients where a serious medical complication was missed on a virtual visit.Conclusions: Now more than a year into the pandemic, telemedicine has clearly been a useful tool by limiting unnecessary hospital visits. Yet, as our cases illustrate, its use in oncology without clear boundary can undermine the quality of care. Now that effective vaccines are reducing the transmission and the severity of infection, most oncology patients can be evaluated by a real-time visit.

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Improving personalised care and support planning for people living with treatable-but-not-curable cancer

Le Boutillier,

Jeyasingh-Jacob,

Jones

et al. 2023

BMJ Open Qual

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People living with treatable-but-not-curable (TbnC) cancer encounter cancer-related needs. While the NHS long-term plan commits to offering a Holistic Needs Assessment (HNA) and care plan to all people diagnosed with cancer, the content, delivery and timing of this intervention differs across practice. Understanding how people make sense of their cancer experience can support personalised care. A conceptual framework based on personal narratives of living with and beyond cancer (across different cancer types and all stages of the disease trajectory), identified three interlinked themes: Adversity, Restoration and Compatibility, resulting in the ARC framework.Our aim was to use the ARC framework to underpin the HNA to improve the experience of personalised care and support planning for people living with TbnC cancer. We used clinical work experience to operationalise the ARC framework and develop the intervention, called the ARC HNA, and service-level structure, called the ARC clinic. We sought expert input on the proposed content and structure from patients and clinicians through involvement and engagement activities. Delivered alongside standard care, the ARC HNA was piloted with patients on the TbnC cancer (myeloma and metastatic breast, prostate or lung) pathway, who were 6–24 months into their treatment. Iterations were made to the content, delivery and timing of the intervention based on user feedback.Fifty-one patients received the intervention. An average of 12 new concerns were identified per patient, and 96% of patients achieved at least one of their goals. Patients valued the space for reflection and follow-up, and clinicians valued the collaborative approach to meeting patients’ supportive care needs. Compared with routine initial HNA and care plan completion rates of 13%, ARC clinic achieved 90% with all care plans shared with general practitioners. The ARC clinic adopts a novel and proactive approach to delivering HNAs and care plans in a meaningful and personalised way.

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The risks associated with the widespread use of telemedicine in oncology: Four cases and review of the literature

Cited by 4 publications

References 12 publications

Utilization of Virtual Consultations in Facial Plastic Surgery during the COVID-19 Pandemic

Utilization of Virtual Consultations in Facial Plastic Surgery during the COVID-19 Pandemic

The risks associated with the widespread use of telemedicine in oncology: Four cases and review of the literature

Improving personalised care and support planning for people living with treatable-but-not-curable cancer

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