Telemedicine in Cancer Care: Here to Stay

Telemedicine has grown in scope over the past decade. With origins going back to the invention of the telephone, the strategy has most recently been bolstered by the internet and electronic medical records that are accessible to both patients and their doctors.

As you will read in this issue of CURE®, this is a rapidly changing and multidimensional field. A sharp uptick in its use is in full swing to accommodate patient visits that once would have been deemed inappropriate as remote encounters. The COVID-19 pandemic has forced innovation, a frequent consequence in a time of desperate need.

In part, telemedicine has been accelerated and expanded because of the concerns of patients with cancer, especially the assumption that they face a higher risk of infection and its effects. At the same time, medical centers have needed to lower traffic. Technology delivered through popular platforms such as Webex and Zoom is being integrated into electronic medical records to allow care providers and patients to see each other and exchange information that is instantly documented in the chart. Even information from a Fitbit or a device given to a patient to transmit electrocardiogram data can be part of a remote visit.

When the pandemic recedes, it is highly likely that many cancer centers and practices will determine which types of visits can continue from afar and how safe and satisfactory these exchanges can be. This is not just a matter of convenience; telemedicine saves costs and even small risks of injury, exposure to infections and emotional distress. In some cases, access is easier. For example, ophthalmology and dermatology appointments often take some time to set up, yet a quick screening can sometimes be done by video to assess the eye or skin. That might not fully substitute for a regular visit, but at least it can help rule out the need for urgent care.

Surveys indicate that those with cancer have a high degree of satisfaction with virtual visits, yet the safety of relying on these encounters in specific subsets of patients, such as individuals receiving chemotherapy or immunotherapy, requires more analysis. Exactly when is it advisable to skip a physical examination, laboratory tests, scans and other aspects of a clinic visit? Over time, a clearer picture should emerge.

Additionally, more needs to be done on a broader level. Topping the list: Rid the nation of the unjust disparity in who has access to high-speed internet, an essential part of social connection, commerce, education and now health care. This is the oxygen of the new millennium, and not everyone is getting their fair share.