Optimizing telehealth across the cancer care continuum during the COVID-19 national emergency

事实证明，我们在远程医疗方面的经验对于当前应对新冠肺炎危机至关重要，因为我们能够迅速扩大我们的活动规模。这些提升活动的结果产生了很大的影响--我们不仅能够通过将脆弱的癌症患者排除在诊所之外来限制他们对COVID的暴露，而且我们还能够降低所有正在接受积极治疗的患者的患者密度(从而降低他们的暴露)。此外，远程医疗还被用来确保任何被护理提供者视为必要的癌症临床试验，以及所有具有治疗意图的癌症试验在SKCC保持开放。目前，远程医疗被用于3个主要目的：1)会诊前会诊，讨论护理计划，因为诊所的访客和照顾者受到限制；2)对所有合适的患者进行随访，特别是在可以在场外完成实验室测试和成像的情况下；3)访问肿瘤专家-社会工作者团队，因为在COVID危机的背景下，癌症护理具有高度的焦虑性。鉴于由于新冠肺炎紧急事件而导致远程医疗在癌症护理服务中的使用增加的自然实验，我们的假设是远程医疗通过改善患者预后来提高肿瘤护理的质量。

Our experience with telehealth proved essential for current coping with the COVID-19 crisis, in that we were able to rapidly scale our activities. The result of these ramp up activities was of high impact—not only were we able to limit exposure of vulnerable cancer patients to COVID by keeping them out of the clinics, but we were able to reduce patient density (and therefore exposure) for all patients undergoing active treatment. Moreover, telehealth is also being used to ensure that any cancer clinical trial deemed essential by a care provider and all cancer trials with curative intent remain open at SKCC. At present, telehealth is being used for 3 major purposes: 1) pre-visit consultations to discuss care plans, given limits on visitors and caregivers in the clinic; 2) follow-up visits for all suitable patients, especially wherein lab testing and imaging can be completed off site and 3) visits with oncologist-social worker teams, given the high anxiety associated with cancer care in the backdrop of the COVID crisis. Given the natural experiment that resulted in increased telehealth use in cancer care delivery due to the COVID-19 emergency, it is our hypothesis that telehealth enhances the quality of oncology care by improving patient outcomes.