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Article ; Online: Telemedicine health disparities in oncology care.

Wozniak, Anna Maria / Rallis, Kathrine S / Elkaddoum, Ronaldo

2021 Volume 17, Issue 14, Page(s) 1695–1698

MeSH term(s)	COVID-19/epidemiology ; COVID-19/immunology ; COVID-19/prevention & control ; Communicable Disease Control/standards ; Health Services Accessibility/economics ; Health Services Accessibility/statistics & numerical data ; Healthcare Disparities/economics ; Healthcare Disparities/statistics & numerical data ; Humans ; Immunocompromised Host ; Income ; Medical Oncology/economics ; Medical Oncology/methods ; Medical Oncology/standards ; Medical Oncology/statistics & numerical data ; Neoplasms/economics ; Neoplasms/immunology ; Neoplasms/therapy ; Pandemics/economics ; Pandemics/prevention & control ; SARS-CoV-2/immunology ; Telemedicine/economics ; Telemedicine/standards ; Telemedicine/statistics & numerical data ; Videoconferencing/economics ; Videoconferencing/standards ; Videoconferencing/statistics & numerical data ; Vulnerable Populations
Language	English
Publishing date	2021-02-26
Publishing country	England
Document type	Editorial
ZDB-ID	2274956-1
ISSN	1744-8301 ; 1479-6694
ISSN (online)	1744-8301
ISSN	1479-6694
DOI	10.2217/fon-2021-0022
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Article ; Online: Role of telemedicine in head neck cancer.

Mali, Shrikant B

Oral oncology

2024 Volume 151, Page(s) 106746

Abstract: ... strategies for optimal treatments and follow-ups. Digitalized healthcare, including digital health ... speech language pathology telepractice models. Mobile health-based interventions can help cancer survivors increase ... to increase access to care across the cancer continuum, strengthen patients' knowledge and self-management ...

Abstract	Chemo-radiotherapy and head and neck cancers are common adverse outcomes that impact patients' quality of life. The increasing cancer incidence and healthcare service shortages necessitate new strategies for optimal treatments and follow-ups. Digitalized healthcare, including digital health, telemedicine, and telemonitoring, is promising. HNC requires multidisciplinary team intervention, including speech language pathology telepractice models. Mobile health-based interventions can help cancer survivors increase physical activity and improve rehabilitation services. Effective self-management skills can improve outcomes. Advancements in communication technologies have led to telecommunication-based interventions incorporating swallowing exercises, education, monitoring, feedback, self-management, and communication. Home-based remote rehabilitation is urgent, especially during the COVID-19 pandemic, but the optimal strategy and effectiveness of remote interventions remain unclear. Telehealth interventions represent a possible novel approach to increase access to care across the cancer continuum, strengthen patients' knowledge and self-management, provide continuity of services, and enable remote monitoring of symptoms and response to treatment. Telehealth patients are typically younger, more likely to be English-speaking, and more likely to be female. These disparities widened slightly after the start of the pandemic but were also present prior to the pandemic.
MeSH term(s)	Humans ; Female ; Male ; Quality of Life ; Pandemics ; Telemedicine ; Head and Neck Neoplasms/therapy ; Head and Neck Neoplasms/complications ; Deglutition Disorders/etiology
Language	English
Publishing date	2024-03-09
Publishing country	England
Document type	Letter
ZDB-ID	1120465-5
ISSN	1879-0593 ; 0964-1955 ; 1368-8375
ISSN (online)	1879-0593
ISSN	0964-1955 ; 1368-8375
DOI	10.1016/j.oraloncology.2024.106746
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Zs.A 4869: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.A 456: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Telemedicine in geriatric oncology - lessons learned from the COVID-19 experience.

Cabrera Chien, Leana / Uranga, Carolina / Katheria, Vani

Current opinion in supportive and palliative care

2024 Volume 18, Issue 2, Page(s) 100–105

Abstract: ... disparities. The hybrid model of care provides in-person and or remote access to clinicians which may allow ... months, including access to care, telemedicine modes of communication, and the use of technology by older ... adults with cancer. These findings have brought insight into issues regarding healthcare disparities ...

Abstract	Purpose of review: Telemedicine quickly became integrated into healthcare caused by the Coronavirus 19 (COVID-19) pandemic. Rapid use of telemedicine into healthcare systems was supported by the World Health Organization and other prominent national organizations to reduce transmission of the virus while continuing to provide access to care. In this review, we explored the effect of this swift change in care and its impact on older adults with cancer. Recent findings: Older adults are susceptible to the COVID-19 virus caused by various risk factors, such as comorbidity, frailty, decreased immunity, and cancer increases vulnerability to infection, hospitalization, and mortality. We found three major themes emerged in the literature published in the past 18 months, including access to care, telemedicine modes of communication, and the use of technology by older adults with cancer. These findings have brought insight into issues regarding healthcare disparities. Summary: The utilization of telemedicine by older adults with cancer has potential future benefits with the integration of technology preparation prior to the patient's initial visit and addressing known health disparities. The hybrid model of care provides in-person and or remote access to clinicians which may allow older adults with cancer the flexibility needed to obtain quality cancer care.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Telemedicine/organization & administration ; Neoplasms/therapy ; Neoplasms/epidemiology ; Aged ; Health Services Accessibility/organization & administration ; Medical Oncology/organization & administration ; SARS-CoV-2 ; Healthcare Disparities ; Geriatrics/organization & administration ; Pandemics
Language	English
Publishing date	2024-04-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2633726-5
ISSN	1751-4266 ; 1751-4258
ISSN (online)	1751-4266
ISSN	1751-4258
DOI	10.1097/SPC.0000000000000697
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Article ; Online: Variation in telemedicine usage in gynecologic cancer: Are we widening or narrowing disparities?

Smith, Anna Jo Bodurtha / Gleason, Emily G / Andriani, Leslie / Heintz, Jonathan / Ko, Emily M

Gynecologic oncology

2024 Volume 184, Page(s) 160–167

Abstract: ... care disparities. Our objective was to evaluate sociodemographic (race, insurance), patient, health ... cohort study, <30% of patients ever used telemedicine, and significant racial and regional disparities existed ... with at least one visit from March 2020 to October 2021, using a real-world electronic health record-derived ...

Abstract	Introduction: Telemedicine rapidly increased with the COVID-19 pandemic and could reduce cancer care disparities. Our objective was to evaluate sociodemographic (race, insurance), patient, health system, and cancer factors associated with telemedicine use in gynecologic cancers. Methods: We conducted a retrospective cohort study of patients with endometrial cancer and epithelial ovarian cancer with at least one visit from March 2020 to October 2021, using a real-world electronic health record-derived database, representing approximately 800 sites in US academic (14%) and community practices (86%). We used multivariable Poisson regression modeling to analyze the association of ever using telemedicine with patient, sociodemographic, health system, and cancer factors. Results: Of 3950 patients with ovarian cancer, 1119 (28.3%) had at least one telemedicine visit. Of 2510 patients with endometrial cancer, 720 (28.7%) had at least one telemedicine visit. At community cancer practices, patients who identified as Black were less likely to have a telemedicine visit than patients who identified as white in both ovarian and endometrial cancer (Ovarian: RR 0.62, 95% CI 0.42-0.9; Endometrial: RR 0.56, 95% CI 0.38-0.83). Patients in the Southeast, Midwest, West, and Puerto Rico were less likely to have telemedicine visits than patients in the Northeast. Uninsured patients were less likely, and patients with Medicare were more likely, to have one or more telemedicine visit than patients with private insurance. Conclusions: In this national cohort study, <30% of patients ever used telemedicine, and significant racial and regional disparities existed in utilization. Telemedicine expansion efforts should include programs to improve equity in access to telemedicine.
Language	English
Publishing date	2024-02-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	801461-9
ISSN	1095-6859 ; 0090-8258
ISSN (online)	1095-6859
ISSN	0090-8258
DOI	10.1016/j.ygyno.2024.01.047
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Article ; Online: Disparities in telemedicine during COVID-19.

Qian, Alexander S / Schiaffino, Melody K / Nalawade, Vinit / Aziz, Lara / Pacheco, Fernanda V / Nguyen, Bao / Vu, Peter / Patel, Sandip P / Martinez, Maria Elena / Murphy, James D

Cancer medicine

2022 Volume 11, Issue 4, Page(s) 1192–1201

Abstract: ... with telemedicine use during the pandemic. This study evaluated health disparities associated with telemedicine ... who received outpatient medical oncology care within a tertiary care academic healthcare system between January ... Telemedicine can increase access to healthcare, but recent research has shown disparities exist ...

Abstract	Background: Oncology rapidly shifted to telemedicine in response to the COVID-19 pandemic. Telemedicine can increase access to healthcare, but recent research has shown disparities exist with telemedicine use during the pandemic. This study evaluated health disparities associated with telemedicine uptake during the COVID-19 pandemic among cancer patients in a tertiary care academic medical center. Methods: This retrospective cohort study evaluated telemedicine use among adult cancer patients who received outpatient medical oncology care within a tertiary care academic healthcare system between January and September 2020. We used multivariable mixed-effects logistic regression models to determine how telemedicine use varied by patient race/ethnicity, primary language, insurance status, and income level. We assessed geospatial links between zip-code level COVID-19 infection rates and telemedicine use. Results: Among 29,421 patient encounters over the study period, 8,541 (29%) were delivered via telemedicine. Several groups of patients were less likely to use telemedicine, including Hispanic (adjusted odds ratio [aOR] 0.86, p = 0.03), Asian (aOR 0.79, p = 0.002), Spanish-speaking (aOR 0.71, p = 0.0006), low-income (aOR 0.67, p < 0.0001), and those with Medicaid (aOR 0.66, p < 0.0001). Lower rates of telemedicine use were found in zip codes with higher rates of COVID-19 infection. Each 10% increase in COVID-19 infection rates was associated with an 8.3% decrease in telemedicine use (p = 0.002). Conclusions: This study demonstrates racial/ethnic, language, and income-level disparities with telemedicine use, which ultimately led patients with the highest risk of COVID-19 infection to use telemedicine the least. Additional research to better understand actionable barriers will help improve telemedicine access among our underserved populations.
MeSH term(s)	COVID-19/epidemiology ; Healthcare Disparities/ethnology ; Humans ; Logistic Models ; Neoplasms/therapy ; Retrospective Studies ; SARS-CoV-2 ; Telemedicine
Language	English
Publishing date	2022-01-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.4518
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Article ; Online: Barriers and Facilitators to Telemedicine: Can You Hear Me Now?

Lopez, Ana Maria / Lam, Kenneth / Thota, Ramya

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting

2021 Volume 41, Page(s) 25–36

Abstract: ... urgency among patients, health care professionals, and policymakers to facilitate health care devoid ... In its most direct interpretation, telemedicine is medical care provided at a distance ... technology that would make virtual care possible from the home. As the mass implementation of telemedicine ...

Abstract	In its most direct interpretation, telemedicine is medical care provided at a distance. Although telemedicine's use had been steadily increasing, the COVID-19 pandemic prompted an unprecedented interest and urgency among patients, health care professionals, and policymakers to facilitate health care devoid of the need for in-person contact. The growth in personal access to telecommunications technology meant an unprecedented number of people in the United States and around the world had access to the equipment and technology that would make virtual care possible from the home. As the mass implementation of telemedicine unfolded, it became quickly apparent that scaling up the use of telemedicine presented considerable new challenges, some of which worsened disparities. This article describes those challenges by examining the history of telemedicine, its role in both supporting access and creating new barriers to access in trying to get everyone connected, frameworks for thinking about those barriers, and facilitators that may help overcome them, with a particular focus on older adults and patients with cancer in rural communities.
MeSH term(s)	Humans ; Telemedicine/methods
Language	English
Publishing date	2021-05-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2431126-1
ISSN	1548-8756 ; 1548-8748
ISSN (online)	1548-8756
ISSN	1548-8748
DOI	10.1200/EDBK_320827
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Article ; Online: Telemedicine and health disparities: Association between patient characteristics and telemedicine, in-person, telephone and message-based care during the COVID-19 pandemic.

Tong, Ling / George, Ben / Crotty, Bradley H / Somai, Melek / Taylor, Bradley W / Osinski, Kristen / Luo, Jake

IPEM-translation

2022 Volume 3, Page(s) 100010

Abstract: ... and telemedical care at a single tertiary care center in an oncology department. We investigated ... Telemedicine has been an essential form of care since the onset of the COVID-19 pandemic ... However, telemedicine may exacerbate disparities for populations with limited digital literacy or access, such as older ...

Abstract	Telemedicine has been an essential form of care since the onset of the COVID-19 pandemic. However, telemedicine may exacerbate disparities for populations with limited digital literacy or access, such as older adults, racial minorities, patients of low income, rural residences, or limited English proficiency. From March 2020 to March 2022, this retrospective cohort study analyzed the use of in-person, phone/message, and telemedical care at a single tertiary care center in an oncology department. We investigated the association between economic, racial, ethnic, socioeconomic factors and forms of care, including in-person visits, telemedicine-based visits, and telephone/messages. The study results show that telemedicine utilization is lower among patients 65 and older, female patients, American Indian or Alaska Native patients, uninsured patients, and patients who require interpreters during clinical visits. As a result, it is unlikely that telemedicine will provide equal access to clinical care for all populations. On the other hand, in-person care utilization remains low in low-income and rural-living patients compared to the general population, while telephone and message use remains high in low-income and rural-living patients. We conclude that telemedicine is currently unable to close the utilization gap for populations of low socioeconomic status. Patients with low socioeconomic status use in-person care less frequently. For the disadvantaged, unusually high telephone or message utilization is unlikely to provide the same quality as in-person or telemedical care. Understanding the causes of disparity and promoting a solution to improve equal access to care for all patients is critical.
Language	English
Publishing date	2022-10-30
Publishing country	England
Document type	Journal Article
ISSN	2667-2588
ISSN (online)	2667-2588
DOI	10.1016/j.ipemt.2022.100010
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Article ; Online: Telemedicine Utilization in the Ambulatory Palliative Care Setting: Are There Disparities?

Frydman, Julia L / Berkalieva, Asem / Liu, Bian / Scarborough, Bethann M / Mazumdar, Madhu / Smith, Cardinale B

Journal of pain and symptom management

2021 Volume 63, Issue 3, Page(s) 423–429

Abstract: ... Methods: We collected data on patients seen in Supportive Oncology clinic by palliative care clinicians ... in availability, telemedicine has been proposed as one way to improve access to palliative care services ... of telemedicine as compared to in-person visits by patients with cancer in the ambulatory palliative care setting ...

Abstract	Context: Given a shortage of specialty palliative care clinicians and geographic variation in availability, telemedicine has been proposed as one way to improve access to palliative care services for patients with cancer. However, the enduring digital divide raises questions about whether unequal access will exacerbate healthcare disparities. Objectives: To examine factors associated with utilization of telemedicine as compared to in-person visits by patients with cancer in the ambulatory palliative care setting. Methods: We collected data on patients seen in Supportive Oncology clinic by palliative care clinicians with an in-person or telemedicine visit from March 1 to December 30, 2020. A logistic regression with generalized estimating equation was fit to assess the association between visit type and patient characteristics. Results: A total of 491 patients and 1783 visits were identified, including 1061 (60%) in-person visits and 722 (40%) telemedicine visits. Female patients were significantly more likely to utilize telemedicine than male patients (OR 1.46; 95% CI 1.11-1.90). Spanish-speaking patients (OR 0.32, 95% CI 0.17-0.61), those without insurance (OR 0.28, 95% CI 0.15-0.52), and those without an activated patient portal (Inactivated: OR 0.46, 95% CI 0.26-0.82; Pending Activation: OR 0.29, 95% CI 0.18-0.48) were less likely to utilize telemedicine. Conclusion: Our study reveals disparities in telemedicine utilization in the ambulatory palliative care setting for patients with cancer who are male, Spanish-speaking, uninsured, or do not have an activated patient portal. In the wake of the COVID-19 pandemic, we can better meet the palliative care needs of patients with cancer through telemedicine only if equity is kept at the forefront of our discussions.
MeSH term(s)	Ambulatory Care ; COVID-19 ; Female ; Humans ; Male ; Palliative Care ; Pandemics ; SARS-CoV-2 ; Telemedicine
Language	English
Publishing date	2021-10-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639142-4
ISSN	1873-6513 ; 0885-3924
ISSN (online)	1873-6513
ISSN	0885-3924
DOI	10.1016/j.jpainsymman.2021.09.019
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Article: Pursuing Connectivity in Cardio-Oncology Care-The Future of Telemedicine and Artificial Intelligence in Providing Equity and Access to Rural Communities.

Kappel, Coralea / Rushton-Marovac, Moira / Leong, Darryl / Dent, Susan

Frontiers in cardiovascular medicine

2022 Volume 9, Page(s) 927769

Abstract: ... and rural communities in both oncology and cardio-oncology contributes to health care disparities and ... within this sphere and propose a novel model of care to address the disparity in urban vs. rural cardio-oncology ... to explore the potential role of telehealth and artificial intelligence in providing cardio-oncology care ...

Abstract	The aim of this review is to discuss the current health disparities in rural communities and to explore the potential role of telehealth and artificial intelligence in providing cardio-oncology care to underserviced communities. With advancements in early detection and cancer treatment, survivorship has increased. The interplay between cancer and cardiovascular disease, which are the leading causes of morbidity and mortality in this population, has been increasingly recognized. Worldwide, cardio-oncology clinics (COCs) have emerged to deliver a multidisciplinary approach to the care of patients with cancer to mitigate cardiovascular risks while minimizing interruptions in cancer treatment. Despite the value of COCs, the accessibility gap between urban and rural communities in both oncology and cardio-oncology contributes to health care disparities and may be an underrecognized determinant of health globally. Telehealth and artificial intelligence offer opportunities to provide timely care irrespective of rurality. We therefore explore current developments within this sphere and propose a novel model of care to address the disparity in urban vs. rural cardio-oncology using the experience in Canada, a geographically large country with many rural communities.
Language	English
Publishing date	2022-06-13
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2022.927769
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Article ; Online: Inequity in Telemedicine Use Among Patients with Cancer in the Deep South During the COVID-19 Pandemic.

Shao, Connie C / McLeod, M Chandler / Gleason, Lauren T / Dos Santos Marques, Isabel C / Chu, Daniel I / Wallace, Eric L / Fouad, Mona N / Reddy, Sushanth

The oncologist

2022 Volume 27, Issue 7, Page(s) 555–564

Abstract: ... telemedicine use among a large oncology population in the Deep South during the COVID-19 pandemic.: Materials ... unclear if its rapid growth exacerbates disparities in healthcare access. We aimed to characterize ... Background: Telemedicine use has increased significantly during the COVID-19 pandemic. It remains ...

Abstract	Background: Telemedicine use has increased significantly during the COVID-19 pandemic. It remains unclear if its rapid growth exacerbates disparities in healthcare access. We aimed to characterize telemedicine use among a large oncology population in the Deep South during the COVID-19 pandemic. Materials and methods: A retrospective cohort study was performed at the only National Cancer Institute designated-cancer center in Alabama March 2020 to December 2020. With a diverse (26.5% Black, 61% rural) population, this southeastern demographic uniquely reflects historically vulnerable populations. All non-procedural visits at the cancer center from March to December 2020 were included in this study excluding those with a department that had fewer than 100 visits during this time period. Patient and clinic level characteristics were analyzed using t-test and Chi-square to compare characteristics between visit types (in-person versus telemedicine, and video versus audio within telemedicine). Generalized estimating equations were used to identify independent factors associated with telemedicine use and type of telemedicine use. Results: There were 50 519 visits and most were in-person (81.3%). Among telemedicine visits, most were phone based (58.3%). Black race and male sex predicted in-person visits. Telemedicine visits were less likely to have video among patients who were Black, older, male, publicly insured, and from lower income areas. Conclusions: Telemedicine use, specifically with video, is significantly lower among historically vulnerable populations. Understanding barriers to telemedicine use and preferred modalities of communication among different populations will help inform insurance reimbursement and interventions at different socioecological levels to ensure the continued evolution of telemedicine is equitable.
MeSH term(s)	COVID-19/epidemiology ; Humans ; Male ; Neoplasms/epidemiology ; Neoplasms/therapy ; Pandemics ; Retrospective Studies ; Telemedicine
Language	English
Publishing date	2022-03-29
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1409038-7
ISSN	1549-490X ; 1083-7159
ISSN (online)	1549-490X
ISSN	1083-7159
DOI	10.1093/oncolo/oyac046
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