Cancer is a leading cause of death. Worldwide, nearly 10 million people die of cancer each year. That's almost 1 in 6 deaths attributable to the disease.
People who recover from cancer often face a long and difficult journey back to health. Treatment is often expensive and time-consuming, and the side effects and financial repercussions can be debilitating. Furthermore, many newly-diagnosed cancer patients face barriers to care such as lack of access to specialists, limited transportation options, and long wait times for appointments.
Telemedicine, also called telehealth, is a technology-based solution that has the potential to side-step some of these obstacles and improve access to care for cancer patients.
What is telemedicine?
Telemedicine is the practice of using telecommunications and information technologies to provide medical care from a distance. It can be used for everything from consultation and diagnosis to remote monitoring and follow-up care.
The exchange of telemedicine information can be synchronous and real-time, typically via a virtual examination or visit. Alternatively, it can be asynchronous, whereby the patient and clinician exchange information that can be reviewed at the convenience of either party.
It's a revolutionary approach to healthcare. It can improve outcomes and quality of life for cancer patients by increasing access to care, especially for those who live in rural or underserved areas.
How can telemedicine help cancer patients?
Telemedicine can help cancer patients in several ways:
- Consultations with specialists: Telemedicine can connect cancer patients with specialists using real-time video conferencing. Patients can get second opinions and receive expert care without traveling long distances or taking time off work. Access to specialists is particularly important for patients with rare or difficult-to-treat cancers.
- Follow-up care: Cancer patients usually require frequent follow-up appointments to monitor their progress and the side effects of treatment. Telemedicine can make it easier for patients to stay on track with their care by eliminating the need for in-person consultations.
- Education and support: Receiving a cancer diagnosis can be overwhelming. Telemedicine can provide patients with educational materials to help them better understand their condition and make informed decisions about their care. There are also online support groups to help people cope with the psychological impact of cancer.
- Safety: People with cancer are often immunocompromised and more vulnerable to infections, which can be dangerous or even deadly. Telemedicine helps reduce the risk of exposure to illnesses by allowing patients to receive care from the comfort and safety of their own homes.
Thanks to wearable technology like smartwatches, telemedicine can also support the remote monitoring of patients.
How does remote monitoring work?
People can use wearable devices to track their health data and vital signs. The data can then be transmitted to their doctor in real-time. This allows doctors to monitor patients' progress and identify potential problems early on. The earlier interventions can be made, the better the outcomes.
A recent study conducted at 52 community cancer clinics with 1,191 participants with advanced cancer looked into the effectiveness of remote monitoring. The participants received regular care or submitted details of their symptoms using a weekly electronic survey.
The remote monitoring group had around 16% better symptom control and around 35% better physical function than those evaluated less frequently during in-person appointments. They also experienced a 41% better overall health-related quality of life.
The results suggest that electronic systems that support patient-reported outcome (PRO) surveys can help doctors intervene early, thereby improving outcomes.
The researchers now aim to find the best models for widespread implementation and methods of making remote monitoring more efficient for medical practices.
What are the challenges of telemedicine?
Although telemedicine offers many potential benefits, there are some challenges, including:
- Infrastructure: Telemedicine requires a reliable internet connection and access to expensive devices like laptops, smartphones, or tablets. Although people in cities and suburbs tend to have better access to these technologies, those in rural areas often do not.
- Provider training: The professionals who provide care via telemedicine need to be trained in using telecommunications and information technologies.
- Security and privacy: The transmission of health data raises concerns about security and patient privacy. Strong measures need to be in place to protect patient data.
- Reimbursement: Some insurance companies do not reimburse for telemedicine services, making it difficult for patients to access them. However, this is beginning to change.
Does Medicare cover telemedicine?
Yes, Medicare currently covers telehealth services. People with Original Medicare Part B and Medicare Advantage plans are eligible.
The COVID-19 pandemic has seen a rapid escalation in use in both privately insured individuals and Medicare beneficiaries. Only 0.3% of traditional Medicare beneficiaries used telehealth before the pandemic. But between 2019 and 2020, this figure increased 63-fold.
Prior to COVID-19, Medicare telehealth coverage was somewhat restricted. But now, under current law, Medicare covers a wide range of telehealth services without restrictions. Unfortunately, however, this level of coverage is available only temporarily.
The Consolidated Appropriations Act, a $1.5 trillion omnibus spending bill, was signed into law on March 15, 2022. The Act allows for telehealth coverage for Medicare patients for 151 days after the official end of the federal public health emergency (PHE).
The Biden Administration most recently renewed the PHE in April 2022. However, they have stated there will be a 60-day notice before the PHE expires.
The Act extends several temporary telehealth waivers set during the pandemic, including waivers removing geographic requirements and expanding originating sites for telehealth services.
These waivers allow Medicare beneficiaries to receive telehealth services from any location, including their homes. They also expanded the list of medical professionals permitted to offer services, including physical therapists, occupational therapists, speech-language pathologists, and audiologists.
Medicare also covers audio-only telehealth services per the Act.
The legislation also requires a special commission to analyze the use and expenditure of telemedicine under the Medicare program. This data will likely inform future decision-making about the role of telemedicine in Medicare.
Telehealth stakeholders and advocates are hoping that these telehealth flexibilities will become permanent and expedited into law regardless of the pandemic status of the pandemic.
Is telehealth the future of cancer care?
Telemedicine and the option to virtually consult with health care providers are reshaping patients' cancer care experience. Although it cannot completely replace in-person care, telehealth offers many advantages and can improve patient experience and care outcomes.