OA17.04 The Global Impact of COVID-19 on Telehealth and Care for Persons With Thoracic Cancers
Smeltzer M, Bunn B, Choi YS, Coate L, Corona-Cruz J, Drilon A, Duma N, Edelman M, Fidler MJ, Gadgeel S, Goto Y, Herbst R, Hesdorffer M, Higgins K, Labdi B, Leal T, Liu S, Mazotti J, Novello S, Patel S, Popat S, Ramirez R, Reckamp K, Reguart N, Soo R, Tan A, Wolf J, Yano S, Stiles B, and Baird A. OA17.04 The Global Impact of COVID-19 on Telehealth and Care for Persons With Thoracic Cancers. Journal of Thoracic Oncology 2021; 16(10):S879.
J Thorac Oncol
Introduction: The COVID-19 pandemic has resulted in countless challenges and changes in health-systems and healthcare delivery around the world. Face-to-face consultation became the exception rather than the norm. Many people at risk of, and living with, thoracic malignancies experienced significant barriers to accessing care. Telehealth was employed by many providers to engage and monitor patients remotely, thus providing some continuity of care. The aim of this project was to assess the use of telehealth during the pandemic and the wider impact on thoracic cancer care from the perspective of healthcare professionals.
Methods: An English language survey was developed by the IASLC communications committee, and administered using Qualtrics software from April 12, 2021 through May 31, 2021. It was disseminated via the IASLC and others, through multiple modalities. The 24-question survey included multiple choice, Likert scale, and free-response questions: covering two broad themes concerning the impact of the pandemic on (i) the use of telehealth and (ii) lung cancer/mesothelioma care. Some general information was also gathered such as location and primary specialty. Statistical analyses included summary statistics reported for each question by region and provider specialty, compared with Chi-Square tests. Types of Analysis and Data Reporting: Full survey results will be reported for the two study themes (i) the use of telehealth and (ii) impact on lung cancer and mesothelioma care. We will present overall results and stratify by region of the world and provider type. Statistical comparisons across groups will also be reported. Finally, free-response data will be summarized and most frequent themes identified will be reported.
Results: The 141 respondents were most frequently male (63.8%), between 41-50 years old (32.6%), medical oncologists (50.7%), with majority based at academic centres (84.2%). Responses were primarily from North America (37.6%), Europe (31.2%), and Asia (14.9%). During the pandemic most used telehealth for the first time (65.2%) and billing (where appropriate) at normal rates (48.2%); the majority felt that telehealth is here to stay (48.2%). Telehealth visits were conducted by phone call (29.2%) and mixed platforms (35.7%), however ‘Video via e-medical record’ was the preferred method (42.5%). The most common barriers to adoption of telehealth were lack of resources for patients (66.1%) and regulatory limitations (56.2%), with patient interest and lack of institutional resources not rated as barriers (43.1% and 41.4%;, respectively). The top advantages for providers/patients were continuity of care and maintenance of contact with patients (88%-92% of respondents). Top disadvantages for providers were lack of human contact (72.9%), lack of patient internet access/tech knowledge (71.3%) and missing informal aspects of face-to-face visits (71.3%); these also ranked as top concerns for patients (74.8%,74%, 76.1% and 68.4%, respectively). Providers felt that telehealth was most appropriate during surveillance (94.1%) and least so for initial diagnosis (69.8%). Most felt that patients were receptive to telehealth (55.3%), however there was a worry that its use would increase healthcare disparities (29.7%). Overall, most felt that the pandemic had a negative impact on care (68%), with impacts on accessing diagnostics (i.e. biopsy), clinical trials (i.e. reduction in trials), basic/translational research (i.e. decrease in activity) as well as care (i.e. surgery). There was also a decrease in numbers accessing lung cancer screening (86.9%).
Conclusion: Much will need to be done to counteract the negative impacts on care, clinical trials, and research during the COVID-19 pandemic. Although, telehealth has been widely adopted, issues remain such as healthcare access, point of use in the care pathway and telehealth platform selection.