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Donmez E, Kilic B, Dulger Z, Ozdas T. Innovative Cancer Follow-Up with Telehealth: A New Method for Oncology Nurses. Semin Oncol Nurs 2024; 40:151649. [PMID: 38734572 DOI: 10.1016/j.soncn.2024.151649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/31/2024] [Accepted: 04/14/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES Telenavigation (TN) is an innovative cancer follow-up method for oncology nurses. Little is known about the effectiveness of tele-navigation on cancer patients. This study investigated the opinions of healthcare providers (HCPs) and colorectal cancer patients' experience regarding patient follow-up with TN. DATA SOURCES This is a phenomenological qualitative study. Semistructured interviews were conducted with fifteen patients and eight healthcare providers. Participants were selected by purposive sampling. Data were collected from March to October 2022 and analyzed by thematic content analysis. CONCLUSION Six themes emerged that described the experiences of TN: (1) beneficial; (2) psychological state; (3) level of knowledge, (4) technology, (5) health care system, and (6) recommendations. Patients and HCPs found TN practice helpful and reassuring and they recommended expanding these practices within the health system. As a result of the research, the TN program is described as beneficial to patients and healthcare providers. IMPLICATIONS FOR NURSING PRACTICE The TN follow-up is a beneficial implication for colorectal cancer patients undergoing treatment, and it deserves to be more widely deployed. It brings reassurance regarding psychological, reliable data access, and home follow-up. Patients and HCPs reported positive views on telephone follow-up. There is a recommendation that the innovative follow-up technique should be disseminated to the healthcare system and that cancer nurses should be more familiar with this method.
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Affiliation(s)
- Elif Donmez
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye.
| | - Bulent Kilic
- Department of Public Health, Medical Faculty, Dokuz Eylul University, Izmir, Turkiye
| | - Zeynep Dulger
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye
| | - Turkan Ozdas
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye
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2
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Wang T, Giunti G, Goossens R, Melles M. Timing, Indicators, and Approaches to Digital Patient Experience Evaluation: Umbrella Systematic Review. J Med Internet Res 2024; 26:e46308. [PMID: 38315545 PMCID: PMC10877490 DOI: 10.2196/46308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/05/2023] [Accepted: 11/29/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The increasing prevalence of DH applications has outpaced research and practice in digital health (DH) evaluations. Patient experience (PEx) was reported as one of the challenges facing the health system by the World Health Organization. To generate evidence on DH and promote the appropriate integration and use of technologies, a standard evaluation of PEx in DH is required. OBJECTIVE This study aims to systematically identify evaluation timing considerations (ie, when to measure), evaluation indicators (ie, what to measure), and evaluation approaches (ie, how to measure) with regard to digital PEx. The overall aim of this study is to generate an evaluation guide for further improving digital PEx evaluation. METHODS This is a 2-phase study parallel to our previous study. In phase 1, literature reviews related to PEx in DH were systematically searched from Scopus, PubMed, and Web of Science databases. Two independent raters conducted 2 rounds of paper screening, including title and abstract screening and full-text screening, and assessed the interrater reliability for 20% (round 1: 23/115 and round 2: 12/58) random samples using the Fleiss-Cohen coefficient (round 1: k1=0.88 and round 2: k2=0.80). When reaching interrater reliability (k>0.60), TW conducted the rest of the screening process, leaving any uncertainties for group discussions. Overall, 38% (45/119) of the articles were considered eligible for further thematic analysis. In phase 2, to check if there were any meaningful novel insights that would change our conclusions, we performed an updated literature search in which we collected 294 newly published reviews, of which 102 (34.7%) were identified as eligible articles. We considered them to have no important changes to our original results on the research objectives. Therefore, they were not integrated into the synthesis of this review and were used as supplementary materials. RESULTS Our review highlights 5 typical evaluation objectives that serve 5 stakeholder groups separately. We identified a set of key evaluation timing considerations and classified them into 3 categories: intervention maturity stages, timing of the evaluation, and timing of data collection. Information on evaluation indicators of digital PEx was identified and summarized into 3 categories (intervention outputs, patient outcomes, and health care system impact), 9 themes, and 22 subthemes. A set of evaluation theories, common study designs, data collection methods and instruments, and data analysis approaches was captured, which can be used or adapted to evaluate digital PEx. CONCLUSIONS Our findings enabled us to generate an evaluation guide to help DH intervention researchers, designers, developers, and program evaluators evaluate digital PEx. Finally, we propose 6 directions for encouraging further digital PEx evaluation research and practice to address the challenge of poor PEx.
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Affiliation(s)
- Tingting Wang
- Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Guido Giunti
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Clinical Medicine Neurology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Richard Goossens
- Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Marijke Melles
- Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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3
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Grant MJ, Chiang AC. Telehealth and Outcomes in Patients With Cancer: Data and Innovation. Cancer J 2024; 30:16-21. [PMID: 38265921 DOI: 10.1097/ppo.0000000000000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
ABSTRACT Despite that telehealth has been crucial to the delivery of oncology care during the COVID-19 pandemic, the impact of this care delivery mechanism on outcomes in cancer care has not been rigorously studied relative standard in-person care for patients with cancer. Patient-centered outcomes such as quality of life, patient satisfaction, and symptoms are important outcomes that have been the primary focus of many of the existing studies in this space, yet only a select few have evaluated overall survival and other objective efficacy endpoints. Studies have alluded to positive effects of telehealth on mitigating financial toxicity and enhancing cost-effective care delivery in oncology. Telehealth carries much potential for advancing care for patients with cancer, but future study should focus on additional efficacy endpoints, implementation, and ways to reduce disparities.
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Kieran R, Murphy C, Maher E, Buchalter J, Sukor S, Alken S. A permanent legacy of the pandemic? Outcomes of and staff views on the introduction of virtual clinics to an Irish oncology service. Ir J Med Sci 2023; 192:33-40. [PMID: 35098430 PMCID: PMC8801271 DOI: 10.1007/s11845-021-02892-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/07/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Virtual clinics were introduced to our practice in March 2020. We aimed to assess outcomes from virtual clinics and to assess staff views on them and their barriers to implementation nationally. METHODS We prospectively assessed outcomes from 53 planned virtual consultations in a cancer centre oncology outpatient department (April-July 2020). Thirty-two oncologists completed an online survey. RESULTS Visit durations ranged from < 5 min (n = 2, 4%) to 30 + min/patient (n = 9, 20%) (median: 18 min (range 4-141, IQR 10-30 min)). Median time spent preparing for patients who did not attend (n = 6, 11%) was 15 min (range 9-15 min). Most patients were scheduled for routine follow-up (n = 41, 87%), with some planned for an early in-person visit (n = 3) or investigation (n = 3). Where bloods had been requested (n = 25), samples had often not been taken (n = 20, 80%) or results were unavailable (n = 3, 12%). Different plans may have been agreed with two patients (4%) had they attended in-person. Virtual visits were perceived as faster by most doctors in the online survey (n = 26, 84%), with some (n = 5, 16%) reporting a difference of 10 min per patient. Many (n = 13, 42%) arranged earlier follow-up appointments. Low satisfaction was associated with difficulty with patient assessment (81%) or communication (63%), resource limitation (48%), or poor access to results of investigations (40%). The majority (n = 21, 67%) do not feel their virtual clinic quality is as good as in-person. CONCLUSIONS If virtual clinics are to play a long-term role in oncology, it is essential to monitor clinic quality and plan visits proactively.
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Affiliation(s)
- Ruth Kieran
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland.
| | - Catherine Murphy
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Eileen Maher
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Jemma Buchalter
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Sue Sukor
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Scheryll Alken
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
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5
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Stavrou E, Qiu J, Zafar A, Tramontano AC, Isakoff S, Winer E, Schrag D, Manz C. Breast Medical Oncologists' Perspectives of Telemedicine for Breast Cancer Care: A Survey Study. JCO Oncol Pract 2022; 18:e1447-e1453. [PMID: 35671420 PMCID: PMC9509057 DOI: 10.1200/op.22.00072] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/21/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The COVID-19 pandemic forced rapid adoption of telemedicine (TM) for breast oncology visits in the United States, but the appropriate role of postpandemic TM is uncertain. We sought to understand physician and advance practice practitioner perspectives on the use of TM for outpatient breast cancer care through an electronically administered survey. METHODS Breast medical oncology clinicians at two academic cancer centers and five satellite locations affiliated with the Dana Farber Cancer Institute and the Massachusetts General Cancer Center were invited to respond to a 21-question survey administered in September 2021 about clinicians' perceptions and attitudes toward TM during the previous 12 months. RESULTS Of the 71 survey invitations, 51 clinicians (36 physicians and 15 advance practice practitioners) provided survey responses (response rate = 72%). Ninety-two percent of respondents (n = 47) agreed that TM visits enhance patient care. Ninety-two percent of respondents (n = 46) also agreed that TM is valuable for early-stage breast cancer follow-up visits. Most respondents felt that there was no difference between TM and face-to-face (F2F) visits when it came to patient adherence, ease of ordering tests, ease of accessing patient records, and workflow outside of the visit (82%, 82%, 78%, and 53%, respectively). Fifty-one percent of respondents (n = 26) said that TM was better for timely access to follow-up appointments. Most respondents said that F2F visits were better for seeing physical problems, personal connection with patients, overall quality of visits, and patient-physician communication (100%, 75%, 65%, and 63%, respectively). CONCLUSION Breast clinicians believe that TM is a valuable tool to enhance outpatient breast cancer care. TM was felt to be appropriate for routine follow-up visits and second opinion consultations and is as good as or better than F2F visits for several routine aspects of breast cancer care.
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Affiliation(s)
| | | | - Affan Zafar
- Dana Farber Cancer Institute
- Harvard Medical School
- Brigham and Women's Hospital
| | | | - Steven Isakoff
- Harvard Medical School
- Massachusetts General Cancer Center
| | - Eric Winer
- Dana Farber Cancer Institute
- Harvard Medical School
| | | | - Christopher Manz
- Dana Farber Cancer Institute
- Harvard Medical School
- Brigham and Women's Hospital
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6
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Wang T, Giunti G, Melles M, Goossens R. Digital Patient Experience: Umbrella Systematic Review. J Med Internet Res 2022; 24:e37952. [PMID: 35925651 PMCID: PMC9389377 DOI: 10.2196/37952] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The adoption and use of technology have significantly changed health care delivery. Patient experience has become a significant factor in the entire spectrum of patient-centered health care delivery. Digital health facilitates further improvement and empowerment of patient experiences. Therefore, the design of digital health is served by insights into the barriers to and facilitators of digital patient experience (PEx). OBJECTIVE This study aimed to systematically review the influencing factors and design considerations of PEx in digital health from the literature and generate design guidelines for further improvement of PEx in digital health. METHODS We performed an umbrella systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. We searched Scopus, PubMed, and Web of Science databases. Two rounds of small random sampling (20%) were independently reviewed by 2 reviewers who evaluated the eligibility of the articles against the selection criteria. Two-round interrater reliability was assessed using the Fleiss-Cohen coefficient (k1=0.88 and k2=0.80). Thematic analysis was applied to analyze the extracted data based on a small set of a priori categories. RESULTS The search yielded 173 records, of which 45 (26%) were selected for data analysis. Findings and conclusions showed a great diversity; most studies presented a set of themes (19/45, 42%) or descriptive information only (16/45, 36%). The digital PEx-related influencing factors were classified into 9 categories: patient capability, patient opportunity, patient motivation, intervention technology, intervention functionality, intervention interaction design, organizational environment, physical environment, and social environment. These can have three types of impacts: positive, negative, or double edged. We captured 4 design constructs (personalization, information, navigation, and visualization) and 3 design methods (human-centered or user-centered design, co-design or participatory design, and inclusive design) as design considerations. CONCLUSIONS We propose the following definition for digital PEx: "Digital patient experience is the sum of all interactions affected by a patient's behavioral determinants, framed by digital technologies, and shaped by organizational culture, that influence patient perceptions across the continuum of care channeling digital health." In this study, we constructed a design and evaluation framework that contains 4 phases-define design, define evaluation, design ideation, and design evaluation-and 9 design guidelines to help digital health designers and developers address digital PEx throughout the entire design process. Finally, our review suggests 6 directions for future digital PEx-related research.
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Affiliation(s)
- Tingting Wang
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Guido Giunti
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
- Digital Health Design and Development, University of Oulu, Oulu, Finland
| | - Marijke Melles
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Richard Goossens
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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7
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Lebar K, Chandra S, Hollander JE. Role of nursing in telehealth. Nursing 2022; 52:42-46. [PMID: 35609077 DOI: 10.1097/01.nurse.0000829908.44004.9a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This article explores the types, features, and benefits of telehealth-including a sample telehealth program-and discusses the role of nurses in the efficient delivery and improvement of telehealth systems.
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Affiliation(s)
- Kiersten Lebar
- Kiersten LeBar is the vice president for Advanced Practice Providers at Jefferson Health in Philadelphia, Pa. Shruti Chandra is an assistant professor of Emergency Medicine at Thomas Jefferson University, where Judd E. Hollander is the senior vice president of Healthcare Delivery Innovation, the associate dean for Strategic Health Initiatives at Sidney Kimmel Medical College, and a professor and the vice-chair of Finance and Healthcare Enterprises in the Department of Emergency Medicine
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8
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Butt Z, Kirsten L, Beatty L, Kelly B, Dhillon H, Shaw JM. Barriers and enablers to implementing telehealth consultations in psycho-oncology. Psychooncology 2022; 31:1365-1373. [PMID: 35460322 PMCID: PMC9545227 DOI: 10.1002/pon.5939] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/21/2022] [Accepted: 04/05/2022] [Indexed: 11/09/2022]
Abstract
Objective In response to the COVID‐19 pandemic, use of telehealth to deliver care was recommended across the Australian health system. This study aims to explore the barriers and enablers to delivery of psycho‐oncology services via telehealth and attitudes to use of telehealth in psycho‐oncology. Methods Twenty‐one psycho‐oncology clinicians participated in semi‐structured telephone interviews. Transcribed interviews were thematically analysed using the framework method. Results Three key themes were identified which described the overall experience of delivering psycho‐oncology services via telehealth: (1) Context Matters‐for whom is telehealth effective, when is it less effective; (2) Therapy content and telehealth implementation; (3) Recommendations for Sustainability. Conclusions These insights into the barriers and enablers to delivering psycho‐oncology services via telehealth inform future research and clinical practice. While there is support for the continued use of telehealth in psycho‐oncology, there are significant improvements needed to ensure effective implementation and continued benefit.
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Affiliation(s)
- Zoe Butt
- The University of Sydney, School of Psychology, Psycho-Oncology Co-operative Research Group (PoCoG), Sydney, New South Wales, Australia
| | - Laura Kirsten
- Nepean Cancer Care Centre, Penrith, New South Wales, Australia
| | - Lisa Beatty
- Flinders University, College of Education, Psychology and Social Work, Adelaide, South Australia, Australia
| | - Brian Kelly
- University of Newcastle, School of Medicine and Public Health, Newcastle, New South Wales, Australia
| | - Haryana Dhillon
- The University of Sydney, School of Psychology, Psycho-Oncology Co-operative Research Group (PoCoG), Sydney, New South Wales, Australia
| | - Joanne M Shaw
- The University of Sydney, School of Psychology, Psycho-Oncology Co-operative Research Group (PoCoG), Sydney, New South Wales, Australia
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9
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He Y, Han X, Zou W, Liu X, Sun N, Zhou F. Telerehabilitation programmes for patients with cancer and survivors: a protocol for a systematic review. BMJ Open 2022; 12:e058981. [PMID: 35393328 PMCID: PMC8991069 DOI: 10.1136/bmjopen-2021-058981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The global cancer burden is a major public health problem. Cancer rehabilitation is an essential component of survivorship care for preventing complications, decreasing symptoms and improving functional quality of life (QOL). In addition to pre-existing challenges, the COVID-19 pandemic has greatly affected cancer rehabilitation programmes and their delivery to patients. This comprehensive systematic review will assess the efficacy and safety of telerehabilitation on functional outcomes and QOL in patients with cancer and survivors. METHODS AND ANALYSIS This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. The following key electronic bibliographic databases will be searched from their inception to April 2021: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials and Physiotherapy Evidence Database (PEDro). We will include randomised controlled trials (RCTs) published in English that examine the effects of telerehabilitation programmes on patients with cancer and survivors. The terms 'telerehabilitation', 'neoplasm', 'RCT' and their analogous terms will be used in our search strategy. Two reviewers will independently complete the study screening, selection, data extraction and quality rating. The PEDro scale will be used to assess the methodological quality of the included studies. Narrative or quantitative synthesis will be conducted on the basis of the final data. The planned start and end dates for the study are 1 March 2021 and 1 May 2022, respectively. ETHICS AND DISSEMINATION Ethical approval will not be required for this review, and the results will be disseminated in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42021243467.
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Affiliation(s)
- Yu He
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
- Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, Liaoning, China
| | - Xiaochai Han
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Wenchen Zou
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xuemin Liu
- Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, Liaoning, China
| | - Nianyi Sun
- Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, Liaoning, China
- Department of Rehabilitation, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Fenghua Zhou
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
- Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, Liaoning, China
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10
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Daguenet E, Magné N. [Use of telehealth services in the oncology setting: Daily routine and during sanitary crisis]. Bull Cancer 2021; 108:627-634. [PMID: 33896585 DOI: 10.1016/j.bulcan.2021.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/29/2020] [Accepted: 01/20/2021] [Indexed: 10/21/2022]
Abstract
Telemedicine is booming with different sub-domains, including telehealth consultation. Pathology chronicity as well as the increased use of health services are two characteristics that underline the importance of telehealth consultation for patient's needs and health professionals. The actual viral pandemic has inadvertently aided the adoption of telehealth, including in medical oncology, radiotherapy and hematology departments. To date, numerous tools are available to accelerate the digital transformation in clinical practice. In this review of the literature, we detail the historical and legal set up of telemedicine, focusing especially on teleconsultation and teleoncology.
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Affiliation(s)
- Elisabeth Daguenet
- Institut de cancérologie Lucien Neuwirth, département universitaire de la recherche et de l'enseignement, 42270 Saint-Priest-en-Jarez, France; Institut de cancérologie Lucien-Neuwirth, département d'hématologie et de thérapie cellulaire, 42270 Saint-Priest-en-Jarez, France
| | - Nicolas Magné
- Institut de cancérologie Lucien Neuwirth, département universitaire de la recherche et de l'enseignement, 42270 Saint-Priest-en-Jarez, France; Laboratoire de radiobiologie moléculaire et cellulaire, UMR CNRS5822/IN2P3, IPNL, PRISME, 69622 Villeurbanne, France.
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11
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Patt D. Using Clinical Informatics to Navigate a Crisis: How Technology and Policy Change Can Influence Cancer Care Delivery. JCO Clin Cancer Inform 2021; 4:318-320. [PMID: 32282231 DOI: 10.1200/cci.20.00033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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12
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Elston Lafata J, Smith AB, Wood WA, Fitzpatrick B, Royce TJ. Virtual Visits in Oncology: Enhancing Care Quality While Designing for Equity. JCO Oncol Pract 2021; 17:220-223. [PMID: 33539180 DOI: 10.1200/op.20.00645] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jennifer Elston Lafata
- Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC.,UNC Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Angela B Smith
- UNC Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Department of Urology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - William A Wood
- UNC Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brendan Fitzpatrick
- UNC Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.,UNC Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Trevor J Royce
- UNC Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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13
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Levine OH, McGillion M, Levine M. Virtual Cancer Care During the COVID-19 Pandemic and Beyond: A Call for Evaluation. JMIR Cancer 2020; 6:e24222. [PMID: 33180741 PMCID: PMC7717920 DOI: 10.2196/24222] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022] Open
Abstract
The interplay of virtual care and cancer care in the context of the COVID-19 pandemic is unique and unprecedented. Patients with cancer are at increased risk of SARS-CoV-2 infection and have worse outcomes than patients with COVID-19 who do not have cancer. Virtual care has been introduced quickly and extemporaneously in cancer treatment centers worldwide to maintain COVID-19-free zones. The outbreak of COVID-19 in a cancer center could have devastating consequences. The virtual care intervention that was first used in our cancer center, as well as many others, was a landline telephone in an office or clinic that connected a clinician with a patient. There is a lack of virtual care evaluation from the perspectives of patients and oncology health care providers. A number of factors for assessing oncology care delivered through a virtual care intervention have been described, including patient rapport, frailty, delicate conversations, team-based care, resident education, patient safety, technical effectiveness, privacy, operational effectiveness, and resource utilization. These factors are organized according to the National Quality Forum framework for the assessment of telehealth in oncology. This includes the following 4 domains of assessing outcomes: experience, access to care, effectiveness, and financial impact or cost. In terms of virtual care and oncology, the pandemic has opened the door to change. The lessons learned during the initial period of the pandemic have given rise to opportunities for the evolution of long-term virtual care. The opportunity to evaluate and improve virtual care should be seized upon.
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Affiliation(s)
- Oren Hannun Levine
- Department of Oncology, McMaster University, Hamilton, ON, Canada.,Hamilton Health Sciences - Juravinski Cancer Centre, Hamilton, ON, Canada
| | | | - Mark Levine
- Department of Oncology, McMaster University, Hamilton, ON, Canada.,Hamilton Health Sciences - Juravinski Cancer Centre, Hamilton, ON, Canada
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14
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Goenka A, Ma D, Teckie S, Alfano C, Bloom B, Hwang J, Potters L. Implementation of Telehealth in Radiation Oncology: Rapid Integration During COVID-19 and Its Future Role in Our Practice. Adv Radiat Oncol 2020; 6:100575. [PMID: 33073060 PMCID: PMC7546643 DOI: 10.1016/j.adro.2020.09.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/18/2020] [Accepted: 09/20/2020] [Indexed: 12/30/2022] Open
Abstract
Purpose The widespread coronavirus disease 2019 (COVID-19) pandemic has resulted in significant changes in care delivery among radiation oncology practices and has demanded the rapid incorporation of telehealth. However, the impact of a large-scale transition to telehealth in radiation oncology on patient access to care and the viability of care delivery are largely unknown. In this manuscript, we review our implementation and report data on patient access to care and billing implications. Because telehealth is likely to continue after COVID-19, we propose a radiation oncology–specific algorithm for telehealth. Methods and Materials In March 2020, our department began to use telehealth for all new consults, posttreatment encounters, and follow-up appointments. Billable encounters from January to April 2020 were reviewed and categorized into 1 of the following visit types: in-person, telephonic, or 2-way audio-video. Logistic regression models tested whether visit type differed by patient age, income, or provider. Results There was a 35% decrease in billable activity from January to April. In-person visits decreased from 100% to 21%. Sixty percent of telehealth appointments in April were performed with 2-way audio-video and 40% by telephone only. In-person consultation visits were associated with higher billing codes compared with 2-way audio-video telehealth visits (P < .01). No difference was seen for follow-up visits. Univariate and multivariable analysis identified that older patient age was associated with reduced likelihood of 2-way audio-video encounters (P < .01). The physician conducting the telehealth appointment was also associated with the type of visit (P < .01). Patient income was not associated with the type of telehealth visit. Conclusions Since the onset of the COVID-19 pandemic, we have been able to move the majority of patient visits to telehealth but have observed inconsistent utilization of the audio-video telehealth platform. We present guidelines and quality metrics for incorporating telehealth into radiation oncology practice, based on type of encounter and disease subsite.
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Affiliation(s)
- Anuj Goenka
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, New York.,Cancer Care Management and Research, Northwell Health Cancer Institute, Lake Success, New York
| | - Daniel Ma
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, New York.,Cancer Care Management and Research, Northwell Health Cancer Institute, Lake Success, New York
| | - Sewit Teckie
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, New York.,Cancer Care Management and Research, Northwell Health Cancer Institute, Lake Success, New York
| | - Catherine Alfano
- Zucker School of Medicine at Northwell/Hofstra, Hempstead, New York
| | - Beatrice Bloom
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, New York.,Cancer Care Management and Research, Northwell Health Cancer Institute, Lake Success, New York
| | - Jamie Hwang
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, New York.,Cancer Care Management and Research, Northwell Health Cancer Institute, Lake Success, New York
| | - Louis Potters
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, New York.,Cancer Care Management and Research, Northwell Health Cancer Institute, Lake Success, New York
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15
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COVID-19 pandemic and clinical psychology placements: a provisional psychologist's perspective. ACTA ACUST UNITED AC 2020; 2:e36. [PMID: 34192276 PMCID: PMC7505032 DOI: 10.1097/or9.0000000000000036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/24/2020] [Indexed: 11/26/2022]
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16
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Affiliation(s)
- Adam P Dicker
- Adam P. Dicker, Sidney Kimmel Cancer Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; and Heather S.L. Jim, Moffit Cancer Center, Tampa, FL
| | - Heather S L Jim
- Adam P. Dicker, Sidney Kimmel Cancer Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; and Heather S.L. Jim, Moffit Cancer Center, Tampa, FL
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