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The new normal

Optimising patient care in a virtual world

The global COVID-19 pandemic has forced the world to consider new ways of working together. How can virtualisation of care help clinicians and patients to thrive in this new normal?

Unlocking the potential of digital technologies in cancer care

Virtualisation of care: COVID-19 and beyond

Virtual care efforts are increasingly becoming an indispensable part of cancer care, with the potential to improve patient outcomes and efficiencies of healthcare provision.


Healthcare centres across the world have experienced the effects of a reduction in face-to-face care, including: delayed diagnosis, altered treatment pathways, sub-optimal or delayed patient care, and suspension of clinical trials during the pandemic.1 In a global survey of 910 physicians (conducted between April and May 2020), 88% reported facing challenges, with over one-third of the 356 centres included experiencing interruptions to cancer-specific care.2 Additionally, cancer patients appear to have an increased risk of both contracting COVID-19 and presenting with a more severe disease course than non-cancer patients;3-5 therefore, continued patient care is particularly important and this is where virtualisation of care can help.

Some examples of challenges posed by the COVID-19 pandemic and their potential digital solutions for cancer care are highlighted in the table below:

Challenges Digital solution(s)
Reduced face-to-face time between clinicians and patients leading to delayed diagnosis and treatment Video/teleconferencing platforms are available for triaging patients and for consultations that do not require physical presence.

Digital patient engagement, monitoring and management apps allow the clinician and patient to remain connected between clinic visits. They also enable collection of patient-reported parameters, such as symptoms and quality of life measures, and passive collection of parameters using wearable devices.
Coordinating care with other specialists and across care settings has become more difficult Digital coordination solutions, such as cloud-based platforms, enable access and sharing of patient data across care settings.
Cancellation or delay of multi-disciplinary team meetings or tumor boards delays timely determination and initiation of treatment Cloud-based care coordination solutions, in combination with teleconferencing platforms, can facilitate virtual tumor board sessions. This allows attendees to share patient data immediately, present patient cases during a tumor board meeting and integrate clinical decision support tools into patient care.
Difficulty collating and preparing complex patient data and coordinating in-hospital and virtual care episodes remotely along the patient journey Cloud-based care coordination tools can collate data from different sources within and outside the healthcare provider facility and present these data in a contextualised format to the care team. Such tools can also support optimised online scheduling of diagnostics and therapeutic procedures.
Decreased recruitment to clinical studies, limiting access to potentially beneficial therapy options Virtual care coordination tools that integrate with clinical study databases and recruitment services allow a fully digitalised and personalised matching of patients with ongoing studies and facilitate the sign-up process.


Acceptance and adoption of virtualisation of care by oncologists across the globe is also increasing, as reflected by its inclusion in the recommendations regarding cancer care delivery from the American Society of Clinical Oncology (ASCO)6 and the strategies for patient management and follow-up from the European Society for Medical Oncology (ESMO) multi-disciplinary expert consensus.7

Click the images below to access the full whitepaper and watch some success story videos of switching from face-to-face to virtualisation of care for patient consultations and multi-disciplinary tumor boards.

Continuing patient consultations in a pandemic

In this video, Alex Pimenta, MD, shares his experience of establishing a framework for virtual patient consultation in Brazil, where teleconsultation wasn’t permitted prior to the pandemic

Molecular tumor board networks: sharing is caring

In this video, Henning Schulze-Bergkamen, MD, shares his experience in establishing an inter-regional, virtual, molecular tumor board network in Germany. and how clinicians can do something similar in their practice.

Continuing the multi-disciplinary tumor board in a crisis

In this video, Kristin Rojas, MD, FACS, FACOG, shares her experience of introducing virtual tumor boards in her centre and offers advice for fellow clinicians making the switch to virtual.

Unlocking the potential of digital technologies in cancer care
 

Preserving the MDT discussion is key
"Preserving the MDT discussion is key" - Kristin Rojas, MD, FACS, FACOG

Multi-disciplinary tumor boards are integral to cancer treatment plans; however, case preparation can be time-consuming and the board can fail to reach a treatment decision in up to 50% of cases. Reasons that tumor boards can be ineffective include: lack of information available for the case, excessive caseload, low attendance, poor team working and lack of leadership.8

We had to migrate to virtual tumor boards within two weeks
"We had to migrate to virtual tumor boards within two weeks" - Alexandria Phan, MD, FACP

Holding tumor board meetings virtually could help remove some of these barriers, and challenges such as lack of information and excessive caseload could be resolved using cloud-based tumor board solutions, which can automatically collect data from multiple sources and arrange those data in an easily-accessible format, potentially reducing case preparation and discussion times.9
 

In a recent survey (December 2020), more than 90% of clinicians stated that they attend virtual team meetings at least monthly and almost 60% used digital tumor board solutions at least monthly.a

For inspiration on how to improve your tumor board efficiencies, explore the success story videos and the tumor board effectiveness guide (created by Professor Phan and Dr Rojas) below by clicking on the images:

The no-nonsense approach to switching to virtual tumor boards

In this video, Alexandria Phan, MD, FACP, shares how her team switched to using a cloud-based tumor board solution within just two weeks, leading to immediate benefits and increased clinician attendance.

Digital tumor board solutions can improve team efficiencies

In this video, Richard Hammer, MD, PhD, shares data from his recent publications on how digital tumor board solutions can improve case preparation and discussion.

Virtualisation of care: COVID-19 and beyond

In the past, virtual care mainly referred to visits that took place between patients and clinicians using digital communication technologies. Today, virtualisation of care encompasses a rapidly broadening range of services that enable the delivery of healthcare remotely using digital tools and devices. For example, in the UK, 99% of general practices (primary care) have switched to virtual consultation to triage patients before offering face-to-face appointments, if required.10 In the United States, 76% of clinicians were interested in using telehealth in April 2020, and 46% were already using it, compared with only 11% in 2019.11 The proportion of virtual and face-to-face interactions in healthcare centres has shifted drastically: prior to COVID-19, 15–19% of physicians stated that their interactions with patients and other clinicians were mostly or all virtual compared with 40% and 70%, respectively, in current practice.a

Click the image below for an interview with Okan Ekinci, MD, about the potential of virtualisation of care during COVID-19 and beyond.

Results from a survey completed by 84 clinicians in December 2020, who registered to attend a virtualisation of care symposium organised by Roche Information Solutions.
 

References

  1. Richards M, et al. The impact of the COVID-19 pandemic on cancer care. Nat Cancer. 2020:10.1038/s43018-020-0074-y.
  2. Jazieh AR, et al. Oncologists knowledge, attitude and practice in COVID-19 pandemic and its negative impact on them: An international study. Annals of Oncology. 2020;31:S4 (poster presentation).
  3. Liang W, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21:335-7.
  4. Yu J, et al. SARS-CoV-2 Transmission in Patients With Cancer at a Tertiary Care Hospital in Wuhan, China. JAMA Oncol. 2020;6:1108-10.
  5. Miyashita H, et al. Do patients with cancer have a poorer prognosis of COVID-19? An experience in New York City. Ann Oncol. 2020;31:1088-9.
  6. Hutchings R. Nuffield trust impact of covid on the use of digital tech in the NHS, [Internet; cited March 2021]. Available from: https://www.nuffieldtrust.org.uk/files/2020-08/the-impact-of-covid-19-on-the-use-of-digital-technology-in-the-nhs-web-2.pdf.
  7. McKinsey & Company. Telehealth: A quarter-trillion-dollar post-COVID-19 reality?, [Internet; cited March 2021]. Available from: https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality.
  8. Pennell NA, et al. American Society of Clinical Oncology Road to Recovery Report: Learning From the COVID-19 Experience to Improve Clinical Research and Cancer Care. J Clin Oncol. 2021;39:155-69.
  9. Curigliano G, et al. Managing cancer patients during the COVID-19 pandemic: an ESMO multidisciplinary expert consensus. Ann Oncol. 2020;31:1320-35.
  10. Soukup T, et al. Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. J Multidiscip Healthc. 2018;11:49-61.
  11. Hammer RD, et al. Digital Tumor Board Solutions Have Significant Impact on Case Preparation. JCO Clin Cancer Inform. 2020;4:757-68.

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Tags: Patients, Innovation, Digital health