As we’ve inched past the year mark of the pandemic, amidst the heartache of what has transpired and the fear of what is yet to come, there is an ironic undercurrent of collective chest-puffing—and rightly so. That’s because, across industries and business sectors, we have achieved things never thought possible and transformed at a pace that far exceeded expectations. In the healthcare space, this rapid acceleration came in the form of adopting telemedicine and telehealth.
Over the course of the pandemic, insurers have paid out anywhere from two to ten times more per month for telehealth services in 2020 compared to 2019. The benefits of telehealth, especially during the early days of the pandemic, were clear: convenience, comfort, practice efficiency and, of course, helping control the spread of COVID-19. And while the advancements seen in some specialties may be here to stay, other specialties—such as oncology—may find its new normal more reminiscent of pre-pandemic days when it’s all said and done.
The forced remote environment of telehealth will have longstanding and catastrophic consequences as people delay important screenings and procedures. According to David E. Cohn, MD, MBA, chief medical officer at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James), we have “filled their cancer worry cup with COVID worry” and therefore people are not as proactive in their health as they once were. According to a recent study, hospital outpatient evaluation and management visits in March–July 2020 v. March–July 2019 were down almost 75%; new patient visits were down 70%; and follow-up visits for existing patients decreased by almost 60%. And while we are starting to see these tick back up, time is of the essence.
Also, the impersonal nature of telehealth, and its associated technological shortcomings, hinders the required high-touch patient care in oncology. While the digital divide remains a cross-sectional consideration, posing challenges for the elderly and/or underserved populations, key disease management inputs such as weight and blood pressure can be gathered relatively easily. In oncology, the contextual cues—patients’ interactions with their care group, their general mood and outlook, their physical appearance—are just as meaningful as lab values. But they can be easily lost in this remote environment. Social workers and psychiatrists could offer another interface with patients to gather these intangibles; however, they are in short supply.
So, is there a silver lining to all of this? Dr. Cohn believes so. “My nursing staff has been able to engage more deeply with their patients,” he says. Cancer care team members have found some “free” minutes thanks to telehealth’s efficient patient triaging and just general reduced patient volume. Despite being exhausted and burned out from the emotional strain of the pandemic, they’re using that time the best way they know how: with care and compassion to restore humanity where it is needed most.