Telemedicine for management of patients with lung cancer during COVID-19 in an Italian cancer institute: SmartDoc Project

Abstract

Background: Telemedicine, and particularly video-consulting, has rapidly accelerated since the coronavirus disease 2019 (COVID-19) pandemic outbreak. The role of e-healthcare for the management of patients with lung diseases is evolving. We report the results of the initial experience of the SmartDoc Project, a telemedicine program activated in a cancer center (Istituto Nazionale Tumori) at the epicenter of the COVID-19 pandemic onset in Italy. Method: The SmartDoc project was established to guarantee continuity of healthcare services for patients with lung cancer during the COVID-19 pandemic crisis. The project was promoted within the National Health System to create a regulatory framework to authorize and reimburse telemedicine in its care delivery for all patients. At the end of the virtual meeting, patients were asked to answer an online survey. Results: From June 19 to December 1, 2020, 83 patients participated in the SmartDoc project and received a teleconsultation. The majority of patients were older than 65 years. Among the 83 televisits, 14 (16.9%) were new visits, 2 (2.4%) second opinions, 4 (4.8%) 30-day postsurgery controls, and 63 (75.9%) long-term follow-up visits. A “complete satisfaction” score (5 out of 5 points) was reported in 70.59% of all the respondents; most patients (76.5%) preferred video-consulting and defined it as better than or comparable to an in-person visit. Conclusion: The favorable initial results of this study suggest that telemedicine should continue beyond the pandemic crisis and should be embedded in a more efficient and accessible healthcare system.

Impact of the COVID-19 Pandemic on Cancer Researchers in 2020: A Qualitative Study of Events to Inform Mitigation Strategies

“…It is encouraging to note that in 2021 to date, there has been much investigation of the practicality of telemedicine protocols [e.g. ( 26 – 28 )]. Findings in this regard appear to be somewhat mixed, with some studies suggesting that most participants were happy to continue telemedicine visits [e.g.…”

“…Findings in this regard appear to be somewhat mixed, with some studies suggesting that most participants were happy to continue telemedicine visits [e.g. ( 28 )], and others suggesting that most participants prefer in-person visits [e.g. ( 26 )].…”

A Narrative Review of the Launch and the Deployment of Telemedicine in Italy during the COVID-19 Pandemic

“…The eligibility process applied to the selected references, after the elimination of the duplicated ones, returned 39 works [ 5 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ], including a review focused on the relationship between telemedicine and radiotherapy [ 39 ].…”

“…The study in [ 40 ] reported the evolution of a multidisciplinary center for myocarditis towards a telemedicine system. Important applications are recorded in oncology, such as in breast cancer [ 21 ], lung cancer [ 25 ], connections to the stoma centers [ 29 ], the management of patients with differentiated thyroid cancer [ 39 ], and related radiotherapy applications [ 35 ]. The neurology sector has also recorded an important use of applications in Parkinson’s disease [ 44 ]; in the use of telemedicine for the multidisciplinary assessment of patients with Amyotrophic Lateral Sclerosis [ 47 ]; for multiple sclerosis [ 28 ]; for a headache specialist center; and in applications of telephysiotherapy [ 47 ].…”

“…Several studies have accompanied the use of telemedicine with the application of questionnaires (in some cases even standardized) to investigate acceptance and satisfaction [ 21 , 22 , 25 , 29 , 38 , 43 , 47 ], from which the desire to continue with telemedicine even in post-pandemic periods have also clearly emerged, directly or indirectly. Telemedicine received a high degree of acceptance, for example, in oncology, where both a study on patients with breast cancer [ 21 ] and in the output of a project on lung cancer monitoring [ 25 ] displayed this. The study in [ 22 ] investigated the individual and contextual determinants of the perceived quality of telemedicine and teleassistance services, and willingness to continue with them among patients with diabetes.…”