Thomas Jefferson University Hospital, Philadelphia, PA
Avnish K Bhatia, Lauren Waldman, Melissa Hunt, Amy Leader, Janene Palidora, Megan Sabonjian, Preethi Selvan, Ayaka Shimada, Brooke Worster, Gregory D. Garber
Background: In response to the COVID-19 National Emergency, the Sidney Kimmel Cancer Center (SKCC) medical oncology practice desired to greatly expand telehealth (TH) utilization to decrease patient risk while maintaining access to care. TH utilization requires resources (smart phones, internet) and there are disparities in digital media access in our patient population. A digital literacy survey performed at the SKCC in 2018 noted that 30% of patients used Android phones and > 60% of patients accessed the internet from a PC. Methods: In response to increased TH demand and need for support, the SKCC launched an oncology-dedicated Telehealth Task Force (TTF) to address barriers to TH access. The TTF team consisted of nine full-time individuals with digital and healthcare literacy to assist in telehealth and patient portal troubleshooting. Critical functions of TTF’s targeted patient solutions include; set-up and delivery of smartphones, creating email accounts, performing test visits, creating EHR patient portal accounts, real- time assistance during TH visits with implementation of this intervention beginning on April 3, 2020 with monitoring of patient interactions/touchpoints. Results: The SKCC medical oncology TTF noted increased interactions with patients immediately with a marked increase in the composite of medical oncology appointments completed by TH (51.0% in April 2020 compared to a prior level of 15.7% in March 2020). Additionally, there was a statistically significant increase in the proportion of patients have an active patient portal EHR account during this same period (14.6%; 95% CI, 12.3% to 16.9%; p < 0.0001). Oncology infusion treatment appointments remained relatively consistent over time. Conclusions: The SKCC medical oncology practice experienced an exponential rise in TH utilization during an uncertain public health crisis. Disparity in digital literacy and resources essential for successful TH use were quickly appreciated as potential barriers to access. The creation of a dedicated Telehealth Task Force was critical in maintain access to care for oncology patients given their vulnerability to infection. Further investigation of TH supports to improve TH use are warranted.
Month | TTF touchpoints | Proportion of visits completed via TH (%) | Active patient portal account (%) | Oncology treatment visits |
---|---|---|---|---|
Dec 2019 | - | 1.1% | 38.5% | 2146 |
Jan 2020 | - | 0.9% | 39.0% | 2268 |
Feb 2020 | - | 0.9% | 40.7% | 2051 |
Mar 2020 | - | 15.7% | 51.4% | 2008 |
Apr 2020 | 204 | 51.0% | 66.0% | 1710 |
May 2020 | 146 | 46.2% | 64.3% | 1652 |
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