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Is your cancer program maximizing use of telehealth to improve patient care?

By Deirdre Saulet and Soleil Shah

In our Trending Now in Cancer Care survey, more than 200 cancer programs told us how they use telehealth—both to improve communication between providers and to deliver services to patients.

Tumor boards the most common application of telehealth, but half of respondents don’t use telehealth for provider communication at all

Almost half of survey respondents reported using telehealth for tumor boards, making it by far the most common provider-to-provider application. And for good reason—using telehealth can increase tumor board participation by improving convenience and lessening the time required for travel.

Which of the following provider-to-provider applications do you currently use telehealth for?
Percentage of respondents, 2017


However, the other half of cancer programs do not use telehealth for any provider-to-provider communication. Smaller cancer programs (<700 analytic cases) were more likely than larger cancer programs (>2000 analytic cases) to report not using telehealth for provider-to-provider communication.

Learn about investment considerations for telehealth and more in our Oncology Telehealth Primer.

Most cancer programs don’t use telehealth to provide services to patients

We also asked cancer programs how they are using—or planning to use—telehealth to provide services to patients. Genetic counseling is the most common service currently offered via telehealth, with one-third of programs providing it.

Strikingly, there is a significant drop-off for the next most common services provided via telehealth—medication management (16%) and follow-up visits for patients in active treatment (16%). Symptom monitoring (5%) and onco-fertility counseling are least commonly provided via telehealth. Additionally, when we asked how programs are overcoming barriers to care in another question, offering telehealth services for patients in rural locations was the least commonly reported strategy (14%).

Uptake of telehealth is likely limited due to upfront costs, as well as provider, staff, and patient buy-in. Even more significant, programs continue to struggle with regulatory and reimbursement requirements, such as cross-state licensure restrictions.

Which of the following services do you currently provide or plan to provide to cancer patients via telehealth?
Percentage of respondents, 2017

Telehealth 2

Intention to increase use of telehealth over the next two years varies by facility type and size

Academic medical centers (AMCs) indicate more interest in offering services to cancer patients via telehealth in the near future than other types of respondents. Nearly half of AMCs plan to provide telehealth services for genetic counseling, oral chemotherapy adherence and support, survivorship visits, and/or symptom monitoring in the next two years. Larger cancer programs (>2000 analytic cases), which disproportionately include AMCs, are also more likely to plan to offer telehealth services to patients in the next two years compared to smaller cancer programs (<700 analytic cases).

Learn how to get paid for telehealth services.

Which of the following services do you currently provide or plan to provide to cancer patients via telehealth?
Percentage of respondents, 2017
n=29 AMC cohort

Telehealth 3


This increased likelihood can be explained by large cancer programs and AMCs typically having access to more monetary, technological, and staff resources. In addition, they may serve a more geographically dispersed population, making it more critical for them to tap into telehealth applications.

Creating your program’s telehealth strategy

With shrinking budgets and patients looking for on-demand access, telehealth presents a compelling business case for many organizations. Using it to deliver services and monitor patients can help cancer programs improve patient access, decrease health care costs, and increase provider- and practice-level operational efficiencies. A recent study has even shown that using telehealth for symptom monitoring can improve patient survival. 

So, regardless of facility type or size, it is critical to carefully weigh the effort required to overcome reimbursement, regulatory, and financial barriers against the potential benefits of telehealth. Resource-constrained cancer programs should explore external funding sources, such as state grants and charitable donations, for investing in the necessary telehealth infrastructure.

For more information on trends in telehealth services at cancer programs nationwide, see our Results from our Trending Now in Cancer Care Survey.

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