Tele-oncology

Tele-oncology is the delivery of cancer services via telehealth technologies. Tele-oncology is used for provider-to-provider collaboration, patient consults, education and engagement, and ongoing monitoring and coordination.

Telehealth is commonly used in cancer care to expand access to specialty care, like genetic counseling services and virtual tumor boards.

Tele-oncology applications

• Genetic counseling
• Tumor boards
• Symptom management
• Survivorship
• Nutrition counseling
• Support groups
• Subspecialist consults (e.g., onco-fertility specialist, onco-psychiatric counseling)
• Patient-provider consults
• Provider-to-provider consults
• Biometric monitoring
• Clinical trial follow-up visits
• Follow-up patient visits
• Distress screening
• Post-discharge monitoring
• Palliative care

As oncology faces rising volumes and workforce shortages, particularly in rural areas, telehealth can help expand access and increase capacity. Only 7% of all oncologists practice in rural areas. This access problem is even worse for patients seeking subspecialty care, with only 30 specialists per 100,000 people in rural America.

Although adoption of telehealth in cancer care lagged behind other specialties, tele-oncology adoption rose significantly during Covid-19, as organizations were forced to stand up virtual programs in response to the closure of in-person services. Utilization of tele-oncology increased from 17% in 2019 to 80% in 2020. Moving forward, more organizations expect to use telehealth to distribute constrained resources across systems and expand patient access.

Benefits of tele-oncology

Extends provider capacity

• Expands subspecialists’ reach to rural and underserved populations
• Reduces provider travel time to satellites
• Improves practice-level operational efficiencies

Improves patient access to care

• Increases access to subspecialty services and remote second opinions
• Offers additional support to patients, such as online support groups
• Maximizes patient convenience by bringing care closer to home

Improves care outcomes

• Enables coordination of multidisciplinary team-based care
• Enhances patient monitoring and treatment adherence through online education and RPM
• Drives patient engagement to better manage symptoms

Most tele-oncology visits are a combination of real-time and store-and-forward technologies. Real-time virtual consults are used to connect patients to primary and specialty providers as well as to connect providers to other providers. Increased collaboration between providers and patients is beneficial for oncology patients, many of whom require chronic care management and behavioral health support in addition to their cancer care. Store-and-forward technologies are used to exchange medical information between providers and patients. The exchange of information helps patients access treatment and manage their symptoms to improve their quality of life.

Reimbursement

In the past, widespread adoption of tele-oncology was limited by reimbursement and regulatory hurdles, such as physician cross-state licensure restrictions and limitations on where care is delivered and received. With temporary federal relaxations of telehealth regulations amid the Covid-19 pandemic, adoption of tele-oncology increased significantly to ensure patients had access to care.

Payers have begun to reconsider the value of telehealth in response to the Covid-19 pandemic. While there aren’t cancer-specific telehealth billing codes, oncology programs can benefit from expanded reimbursement for general telehealth services.

Compared to other specialties, telehealth has been underutilized by oncology programs. Now that Covid-19 has forced many oncology programs to adopt and experiment with telehealth services, consider how to sustain your tele-oncology program’s progress to benefit patients and providers.