Remaining Agile in the COVID-19 pandemic healthcare landscape – How we adopted a hybrid telemedicine Geriatric Oncology care model in an academic tertiary cancer center

Chen, Matthew; Said, Noorhanah Mohd; Rais, Nydia Camelia; Ho, Francis; Ling, Natalie; Chun, Meiling; Ng, Yen Kaow; Eng, Wan Nghee; Yao, Yao; Korc‐Grodzicki, Beatriz; Pang, Angela

doi:10.1016/j.jgo.2022.04.006

Cited by 15 publications

(14 citation statements)

References 22 publications

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“…To adapt to this emergency, we attempted to continue providing multidisciplinary geriatric oncology care using telemedicine, as happened in many geriatric oncology clinics [ 11 ]. Institutions in the United States, such as the University of Rochester have also reported their experience with the adoption of telemedicine for geriatric assessment in response to the COVID-19 pandemic [ 12 , 13 ]. However, most teleoncology clinics in the United States have utilised dedicated platforms, which may not be available in LMICs, and which may be difficult to access for older individuals without a personal computer.…”

Section: Discussionmentioning

confidence: 99%

Providing geriatric oncology care using telemedicine for older patients with cancer during the COVID-19 pandemic in Mexico

Hernández-Favela¹,

Jimenez-Sotomayor²,

Morales-Alfaro³

et al. 2023

ecancer

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The objective of this study was to describe our experience using readily available telemedicine tools to deliver specialist multidisciplinary care to older adults with cancer at a Mexican medical centre during the COVID-19 pandemic. Between March 2020 and March 2021, patients aged ≥65 years with colorectal or gastric cancer treated at a geriatric oncology clinic in Mexico City were included. Patients were reached via telemedicine utilising readily available apps such as WhatsApp or Zoom. We performed interventions such as geriatric assessments, treatment toxicity assessments, physical examinations and treatment prescription. The number of visits per patient, type of device used, preferred software/app, consultation barriers and the ability of the team to deliver complex interventions were analysed and reported. A total of 44 patients received at least one telehealth visit, with a total of 167 consultations. Only 20% of patients had webcamequipped computers, and 50% of visits were performed using a caregiver's device. Seventy-five percent of visits took place using WhatsApp, and 23% using Zoom. The average visit lasted 23 minutes, with only 2% not completed due to technical issues. A geriatric assessment was successfully conducted in 81% of telemedicine visits, and chemotherapy was prescribed remotely in 32%. The use of telemedicine is possible in older adults with cancer living in developing countries and with little previous exposure to digital technology using readily available platforms such as WhatsApp. Healthcare centres in developing countries should make efforts to enhance the use of telemedicine, particularly for vulnerable populations such as older adults with cancer.

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Section: Discussionmentioning

confidence: 99%

Providing geriatric oncology care using telemedicine for older patients with cancer during the COVID-19 pandemic in Mexico

Hernández-Favela¹,

Jimenez-Sotomayor²,

Morales-Alfaro³

et al. 2023

ecancer

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“…This also aligns with nongynecologic conditions where portal-assisted patient care may apply. Studies suggest the receptivity of patients and benefit of portals in various medical and surgical conditions 1–7 . However, when integrating the older population in such care options, it is vital to permit older age-appropriate-customization when designing patient portals.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have been increasingly focused on the utility of virtual care and patient portals across specialties and medical conditions. It has proved effective in medical specialties, such as pulmonology and geriatric oncology, and the management of hypertension, diabetes, and dyslipidemia 1–3 . Given the complexity of providing care in surgical specialties, the literature suggests its utility in a wide array of surgical specialties, including but not limited to pediatric surgery, cardiac surgery, and spinal surgery 4–6 .…”

mentioning

confidence: 99%

“…It has proved effective in medical specialties, such as pulmonology and geriatric oncology, and the management of hypertension, diabetes, and dyslipidemia. [1][2][3] Given the complexity of providing care in surgical specialties, the literature suggests its utility in a wide array of surgical specialties, including but not limited to pediatric surgery, cardiac surgery, and spinal surgery. [4][5][6] Studies have suggested high satisfaction when telemedicine is integrated in the field of urogynecology.…”

mentioning

confidence: 99%

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Older Patient Receptivity to the Integration of Patient Portals and Telehealth in Urogynecology: Promoters and Deterrents

Zoorob

Hasbini

2023

UROGC

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Importance Limited studies focus on the integration of online portals, including telehealth services, in urogynecology while identifying promoters and deterrents of utilization, especially for the older population. Objective This study aimed to identify facilitators, concerns, technical or personal issues encountered, and the desired features of the online patient portals among older urogynecology patients. Study Design This is a secondary analysis of a cross-sectional study of older patients (≥65 years). The survey was devised using 2 focus groups with questions addressing older patient practicality and comfort with virtual visits for menopause and urogynecology-specific conditions. Results A total of 205 patients completed the study. Promoters of use included health care professional encouragement, enrollment on site with concurrent education, and clarification of relevance of the virtual care to one's care. Patients who were uncomfortable with portal use reported anxiety and technical issues as deterrents for using such technology. More than half of the patients were comfortable having online visits for preoperative (51.7%), postoperative (66.3%), and medical management (73.7%). Up to 60.5% of the patients believed that virtual visits were equally stressful as in-person visits, whereas 24.4% believed that the logistics of in-person visits were the cause of stress. Conclusions To improve access to care, augment the utilization of online patient portals, and combat ageism, enhancing the older urogynecologic patient's portal experience is vital. Investment in this population's needs includes education of patients, active enrollment, and engagement by health care systems, and addressing technical concerns.

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“…Implementation of DHIs should consider funding mechanisms because they will impact the (cost) evaluation and long-term sustainability. The COVID-19 pandemic has accelerated the need for new funding mechanisms for telehealth solutions, for example, in the United States [ 93 ] and Singapore [ 94 ]. Unfortunately, these funding mechanisms have primarily been ad-hoc.…”

Section: Roadblocks and Solutions To Implement Digital Health Interve...mentioning

confidence: 99%

World Heart Federation Roadmap for Digital Health in Cardiology

et al. 2022

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More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service delivery. Digital health technologies can help address these challenges. They may be a tool to reach Sustainable Development Goal 3.4 and reduce premature mortality from non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation. World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.

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Remaining Agile in the COVID-19 pandemic healthcare landscape – How we adopted a hybrid telemedicine Geriatric Oncology care model in an academic tertiary cancer center

Cited by 15 publications

References 22 publications

Providing geriatric oncology care using telemedicine for older patients with cancer during the COVID-19 pandemic in Mexico

Providing geriatric oncology care using telemedicine for older patients with cancer during the COVID-19 pandemic in Mexico

Older Patient Receptivity to the Integration of Patient Portals and Telehealth in Urogynecology: Promoters and Deterrents

World Heart Federation Roadmap for Digital Health in Cardiology

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