Is Telemedicine Here To Stay Post-Pandemic? New Research Indicates Cancer Patients Prefer Remote Care Over In-Person Visits

Another major side effect of the pandemic, however, has been the push toward more telemedicine healthcare visits. A new study published in the Journal of the National Comprehensive Cancer Network has found that people with cancer prefer telemedicine over in-person appointments.

This study analyzed survey responses from over 1,000 radiation oncology patients receiving treatment at Memorial Sloan Kettering's main campus and six other locations in New York and New Jersey. The responses were based on telemedicine appointments and office visits from December 2019 to June 2020.

Researchers found that 45% of people with cancer prefer telemedicine, 34% prefer hospital visits, and 21% have no preference between the two. Patients reported equal or improved experiences with the switch to telemedicine by multiple metricsconfidence in their health care provider, comprehension of their treatment plan, and confidence that they will receive quality care.

A panel of doctors discuss how telemedicine can be used as a tool to address racial disparities in cancer treatment and healthcare.

In terms of treatment related costs (including travel and lost wages), two thirds of the patients surveyed reported that remote appointments were preferable. Dr. Erin F. Gillespie, one of the study's lead authors, noted the other potential big-picture benefits of allocating more resources to remote healthcare. "Telemedicine takes away most of this cost and inconvenience, and could therefore reduce the overall burden of engaging with the healthcare system. Also, the ability for family and friends to join the conversation from any location can be game-changing," she said.

Though remote visits can be a beneficial substitute for doctor's office visits, visual cues are still an important element of conversations between patients and doctors. Survey responses varied meaningfully between video-chats and audio-only telemedicine meetings, with patients reporting that they would opt for an in-person visit over an audio-only call.

Speaking with News Medical Life Sciences, Dr. Anne Chiang of the Yale Cancer Center said, “Telehealth has transformed cancer care throughout the United States, with widespread adoption in an incredibly short timeframe in response to the pandemic." Based on the results of this study, Dr. Chiang believes that telehealth should be "a permanent transformation of the healthcare landscape."

Remote Cancer Care is Possible

Some cancer care is already available to patients from their home. For example, people who take the chemo drug 5-FU may get a pump that they can take home so the drug can be administered over the course of several days without the patient having to stay in the hospital for all that time.

At some cancer centers, injectable medications started moving to patients' homes during the COVID pandemic. "Patients who have prostate cancer or breast cancer, for example, need hormone therapy, which is usually given as a shot that's once a month, or once every three months. Some of our patients would come into the clinic for that, but it is feasible, oftentimes, for patients to have the medications sent to their home where they can do it themselves," Dr. Nathan Handley of the Penn Center for Cancer Care Innovation told SurvivorNet in a previous interview. Private home infusion services through home health agencies, separate from hospitals, offer some cancer treatments, too.

Telemedicine can be a safe alternative during COVID-19 for care that doesn't require an in-person visit, especially for people with ovarian cancer, who are at an increased risk for infection.

Care At Home Could Be Cheaper, Safer and Better

Research shows that at-home health care programs reduce the total number of days that people stay in the hospital and reduce the risk for hospital readmissions and unplanned hospital and ER visits. They cut patients costs by 30 to 50 percent and increase satisfaction.

When you get your care at home, you lower your exposure to hospital-acquired infections and diseases like COVID-19, too. For people who otherwise might travel long distances for treatment, in-home care gives you more time at home with your family, which can greatly improve your quality of life.

Pushback from Professional Organizations

Though there's substantial emerging evidence for the benefits telemedicine and in-home care, professional associations including the American Society of Clinical Oncology and the Community Oncology Alliance have released statements in opposition of at-home infusions. Both organizations cite patient safety concerns and overall lack of data on the safety of at-home care.

"There's good data from other countries that a home-based regimen can be safe and effective," Dr. Handley says. "There's just less experience with that in the U.S." For some kinds of cancer care, the safety argument will be harder to make.

Find Out If You Can Get Care at Home

Though at-home cancer care is still in its infancy in the US, it's worth asking your care team and your insurance provider whether this type of care is available to you.

Start by asking a member of your care team these questions:

• Can I receive any component of my treatment at home?
• Are there other ways that I can reduce my exposure to the health care system?
• Can any of my doctor visits be telehealth visits?

"We often forget just how burdensome it can be for patients to travel to hospitals for their care," Dr. Handley says. "So, even if you can get a telemedicine appointment instead of an in-person visit, that would be somewhere to start."

Contributing: SurvivorNet staff

Learn more about SurvivorNet's rigorous medical review process.

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