Many thoracic oncologists used telehealth for first time during pandemic
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Almost two-thirds of thoracic oncologists used telehealth for the first time during the COVID-19 pandemic, according to survey results presented at International Association for the Study of Lung Cancer World Conference on Lung Cancer.
“Much will need to be done to counteract the negative impacts on care, clinical trials and research during [the pandemic],” Anne-Marie Baird, PhD, senior research fellow at Trinity College Dublin in Ireland, said in a press release. “Although telehealth has been widely adopted, issues remain, such as health care access, point of use in the care pathway and telehealth platform selection.”
Telemedicine became an essential communications tool for physicians in many specialties during the COVID-19 pandemic, providing an alternative to in-person consultations with patients and helping to overcome the barriers many patients faced with regard to care access.
Baird and colleagues on the IASLC communications committee created a 24-question survey to assess telehealth use during the pandemic and its impact lung cancer or mesothelioma care from the viewpoint of health care professionals.
Researchers administered the survey between April 12 and May 31.
Most of the 141 respondents were male (64%), aged 41 to 60 years (60%) and based at academic centers (84%). The most common specialties included medical oncology (51%), thoracic surgery (17%), pulmonology (10%) and radiation oncology (10%).
More than one-third (38%) practiced in the United States or Canada, whereas 29% practiced in Europe and 15% practiced in Asia.
Nearly two-thirds (63%) of respondents indicated they used telehealth for the first time during the pandemic. The most common forms of telemedicine use included phone calls (29%), a mix of methods (26%), video via a third-party platform (24%) or video via e-medical record (8%).
However, when respondents were asked to indicate their most preferred platform, 43% favored video via e-medical record, followed by mix of phone and video (31%), video via third-party platform (30%) and phone calls (21%).
When researchers assessed barriers to telehealth, they identified lack of patient resources (66%), regulatory limitations (56%) and lack of institutional resources (49%) as the three most common.
A majority (55%) of respondents said they felt patients were receptive to telehealth but 29.7% expressed worry that it would increase health care disparities.
Nearly half (48.2%) indicated they believe telehealth is here to stay, citing continuity of care and the ability to maintain contact with patients as the most important advantages. Nearly all respondents (94%) indicated telehealth is most suitable for surveillance. However, only 69.8% considered it appropriate for initial diagnosis, and more than half (55%) indicated it is not suitable for any point in the care pathway.
When asked about the top disadvantages of telehealth, providers selected lack of human interaction (73%), lack of patients’ internet access or technical knowledge (71%) and missing out on informal aspects of face-to-face visits (71%).
When researchers examined the impact of COVID-19 on the care pathway, most respondents reported fewer presenting patients (83%), delays from transition from primary care to a hospital setting (82%), delays accessing trials (74%) and delays accessing surgery (73%).
A majority also reported a reduction in the number of clinical trials (74%), a halting of current trials (62%), a decrease in research activity (69%) and a reduction in protected research time (61%).
“There are issues around the use of telehealth, and these issues may be addressed by guidelines being formulated and tested to enable the best delivery of care,” Baird said. “Of course, these guidelines may need to look at a more hybrid model, even as the pandemic comes to an end.”
Perspective
Back to TopShani Shilo, DMD, PhD
If anything good came out of the pandemic, it made us adjust and find new means of communication. Telehealth has really been accepted by patients and caregivers, as well as oncologists. Face-to-face meetings are still very important, but telehealth is here to stay and we will continue to use it even after the pandemic.
We have to ensure patients have the means and knowledge to use it, because most patients with lung cancer are older and many live in more rural areas with less digitization.
Regular communication with the health care team can be a big burden for patients and caregivers. Some oncologists or nurses will give their phone numbers or email addresses, but some will not. My hope is that we will be able to further develop telemedicine so it goes beyond scheduled visits and improves day-to-day communication, such as when a patient is experiencing a side effect and needs an answer.
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Baird A-M, et al. Abstract OA17.04. Presented at: International Association for the Study of Lung Cancer World Conference on Lung Cancer (virtual meeting); Sept. 8-14, 2021.
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