MATCHES: Making Telehealth Delivery of Cancer Care at Home Effective and Safe

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Project Summary/Abstract The MATCHES (Making Telehealth Delivery of Cancer Care at Home Effective and Safe) Telehealth Research Center aims to build the evidence base necessary to establish best practices for telehealth-enabled cancer care. The overarching goal of the Center is to create a research hub that generates evidence, trains investigators, and develops the research methods required to ignite the field of precision cancer care delivery. Prior work demonstrates that oncology-focused telehealth can achieve favorable outcomes, but large-scale trials have been limited to specific contexts like palliative care or survivorship. Adoption has been constrained by restricted reimbursement. The MATCHES Center will help remediate this evidence gap by executing prospective trials, conducting observational analyses, and training transdisciplinary researchers. Our research theme focuses on the integration of multi-layered data from telehealth platforms, patient portals, mobile tracking devices, and the electronic medical record to develop analytic methods that support personalized care. We aim to develop a new paradigm in oncology—precision delivery—with the ultimate goal of matching individual patients with the most beneficial combination of clinic-based or telehealth-supported home-setting care at the appropriate time—all based on the totality of dynamically available data. We will accomplish this goal by applying data science methods—including nimble trial designs and machine learning—that have had limited application to telehealth to date. By establishing a research hub that nurtures investigators across disciplines and provides training, tools, data, analytic methods, and venues for sharing knowledge and building partnerships, we expect to accelerate progress in the science of care delivery. Our specific aims are 1) to conduct impactful pragmatic trials of telehealth in oncology, 2) to analyze a large existing cache of multidimensional observational data characterizing telehealth utilization and outcomes, 3) to train investigators and equip them with the skills necessary to innovate within an evidence-based framework, and 4) to integrate telehealth with other data streams and create and apply analytic methods to transform the field of precision care delivery. An Administrative Core will coordinate activities and engage feedback from internal and external stakeholders—including patients and the oncology workforce. Our Clinical Practice Network serves as an innovation laboratory and comprises 7 outpatient clinics in NY and NJ with a shared informatics ecosystem including telehealth capacity, digital monitoring, and a highly trafficked patient portal. This will enable us to launch and execute a large pragmatic trial comparing in-person care to telehealth, with resources designed to support home-based care using a cluster-randomized design. The Research & Methods Core will support the Center by applying data science methods to extract and synthesize insights from telehealth and other data streams to develop methods relevant to advancing precision cancer care delivery and the goals of equity, efficacy, and efficiency to create an optimal experience for people being treated for cancer.