The COVID-19 pandemic has proved to be one of the greatest threats to global health and well-being, impacting millions in a matter of months worldwide.
In the current age, where the standard is at least some degree of social distance and hospitals have emerged as hotspots, it has become imperative for oncologists to formulate methods to provide cancer patients with treatment while minimizing the exposure of patients to healthcare environments.
In the delivery of treatment to cancer patients, telemedicine and tele-health-based approaches have emerged as fairly realistic alternatives to these impediments.
Since most of the ‘daily well-visits’ have been either delayed or cancelled for cancer patients, tele-health-based approaches allow oncologists to remotely take care of their patients and track their progress. Telemedicine, especially for patients with rare cancers who often live far from specialist centres, can revolutionize the delivery of cancer care.
Telemedicine and patient care
Telemedicine facilitates real-time patient evaluation. It offers doctors the ability not only to address changes in symptoms/well-being with patients but also to advise and tell them about needed changes to their care plans. The secret to most cancer patient care strategies is good communication, be it therapy plan meetings, offering supportive care, advance care planning, survivorship, among other items.
Tele-health-based approaches do not compromise, despite common notion, the consistency and strength of contact between doctor and patient. Some studies have actually reported greater patient satisfaction with virtual visits.
For a thorough clinical assessment that involves in-person consultation, physical examination as well as in-site radiological and laboratory investigations, cancer patients on active care typically need in-person visits. However, in view of the current pandemic, it has been proposed that in-patient visits to patients with cancer should be supplemented by virtual visits and that patients should be advised to undergo direct infusion therapy.
Digital divide and telemedicine
At present, in a resource-constrained environment for cancer diagnosis and treatment, we might be missing the necessary technical resources. Not all patients have smartphones or can arrange telemedicine appointments-a obstacle to access is this digital divide.
Nevertheless, illiteracy or lack of awareness of medicines is not a hindrance because patients can send photographs of medicines, prescriptions, blood reports even in remote areas.
New telemedicine guidelines have been issued by the Government of India in which video (telemedicine services, apps, video on chat platforms, Skype/Face time, etc.), audio (phone, VOIP, apps, etc.) and text-based platforms can be used.
Legal structures are being developed and there is also preparation for telemedicine certification.
How can patients be virtually assessed?
Tele-oncology is effective in providing cancer patients with remote chemotherapy control, symptom management, and palliative care. Except in the most remote areas, technical developments have solved the problem of telemedicine communication.
It is worth noting that virtual visits can also act as an exemplary resource for assessing improvements in functional status and tracking patient toxicity related to treatment. Not only can telehealth-based monitoring aid in the initial assessment of patients prior to initiation of treatment, but it can also be used to monitor and monitor patients continuously during and after treatment.
Many hospitals have developed dedicated telemedicine lines, where the patient can log in and make general requests answered by a team of volunteers from the healthcare provider. They may leave their number and are called by the department concerned or a consultant if they need assistance with specialist drugs or have a problem that needs a virtual consultation.
In the midst of the COVID-19 crisis, telemedicine was given top priority to reaching cancer patients, but it has not reached the mature stage of incorporation into the existing delivery of cancer treatment. Telemedicine is not a medication, it’s just a technology, it’s just a catalyst that can help us coordinate our delivery system of cancer care.
Tele-health in oncology is nothing new, with its benefits and setbacks. It has been there for years and has been used in particular to connect rural areas with satisfactory results.
The benefits of tele-oncology clearly outweigh the setbacks in the aftermath of COVID-19, urban lockdown and the risk of contagion. This makes the use of such technology generally appropriate among doctors and patients alike.
More significantly, oncologists and patients are also learning to make use of these innovations. With that being said, large-scale studies are undoubtedly needed to identify ways to improve telehealth and test its acceptability as the current oncology standard of treatment.
In order to integrate virtual treatment into the practice of oncology, care teams and health systems around the world need to concentrate on innovating and evolving newer technologies. Telemedicine is here to remain in cancer treatment and revolutionize it.
(Views And Research of Dr Abhishek Shankar, Assistant Professor in Radiation Oncology at Lady Hardinge Medical College & SSK Hospital, Dr Udhayvir Singh Grewal works in Department of Internal Medicine, Louisiana State University Health Sciences, Dr Deepak Saini is Project Officer at Cancer Control and Prevention Division of Indian Society of Clinical Oncology, Dr Shubham Roy is Fellow in Ummeed Child Development Center, Mumbai)