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COVID-19危机至关重要，因为我们能够迅速扩大活动规模。这些增加活动的结果产生了很大的影响——我们不仅能够通过让易感癌症患者远离诊所来限制他们接触COVID，而且我们能够降低所有接受积极治疗的患者的患者密度（从而减少暴露）。此外，远程保健还用于确保护理提供者认为至关重要的任何癌症临床试验和所有以治疗为目的的癌症试验在SKCC继续进行。目前，远程保健主要用于3个目的：1)考虑到对诊所访客和护理人员的限制，会诊前咨询以讨论护理计划；2)对所有合适的患者进行随访，特别是在实验室测试和成像可以在现场完成的情况下；3)鉴于在COVID危机背景下与癌症护理相关的高度焦虑，与肿瘤学家-社会工作者团队进行随访。鉴于由于COVID-19紧急情况导致远程医疗在癌症治疗中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的治疗结果来提高肿瘤治疗的质量。

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.