One year ago, cancer care – just like everything else – threatened to be disrupted by the onset of the COVID-19 pandemic.
“We had to change our way of practicing medicine and we had to change it fairly quickly,” said Hamid Emamekhoo, MD, a medical oncologist at the UW Carbone Cancer Center. “Because yes, the pandemic was happening, but cancer did not stop. Cancer care needed to be continued, and we had to find ways of adapting.”
One of the biggest shifts at UW Carbone in the wake of COVID-19 was the widespread adoption of telehealth. By conducting some appointments over the phone or by video, oncologists were able to continue providing care to many patients remotely, while reducing touch points and ensuring physical distancing for both patients and clinical staff.
Now, one year after COVID-19 first disrupted our daily lives, there are signs of things tentatively returning to some semblance of normal. Vaccines are being distributed, schools are beginning to re-open, and capacity restrictions are gradually easing up.
Having telehealth as an option for cancer care, however, is likely going to stick around – perhaps permanently.
“I really think telehealth is here to stay,” Emamekhoo said. “Initially, there was some concern about whether a telehealth visit would be an appropriate platform for cancer care and patient evaluation. But a lot of our patients who used this service liked it and feel comfortable using it. Many of my patients are even asking for a virtual visit these days.”
Over the past year, Emamekhoo has been part of a team tasked with building infrastructure around oncology telehealth – and then finding ways to improve on it. While telehealth was used at UW Health prior to COVID-19, the pandemic really accelerated its use across multiple disciplines, including oncology.
Certainly, there were a few hiccups in the beginning, as both patients and providers adjusted to new technologies, as well as new ways of conducting and receiving care. But as the months progressed, telehealth rapidly improved as specific work flows and care protocols were developed and implemented, including specific ways of assessing patients and sharing health information over video.
On top of that, Emamekhoo and his colleagues spent time discussing and implementing strategies aimed at replicating that in-person patient/provider connection. That’s meant getting into the nitty-gritty details, such as learning how to position a webcam at the right angle – and where to fix your gaze – so you’re looking directly at a patient. Or using more non-verbal body language to acknowledge what a patient is saying.
“These are minor things that might have an impact in the way that the patient is receiving this encounter,” Emamekhoo said. “Some of these techniques really help us to have a more personal connection with the patient.”
These days, Emamekhoo estimates that he sees about 30-40 percent of his patients through telehealth. While he knows it may not be for everyone, Emamekhoo believes that telehealth will likely become a more appealing option for some patients, once they try it. And there are plenty of instances where switching to telehealth may make sense. For instance, patients on long-term observation, or even those taking an oral medication without any significant side effects, are good candidates for video visits. Same goes for patients who may live far away from the clinic.
There are plenty of additional benefits, too. Patients can easily bring family members into appointments, even if they are halfway across the country. Additionally, oncologists can easily call on a colleague, or other experts, to pop into an appointment with advice, a second opinion or even with the latest treatment modalities or available clinical trials for a certain cancer.
Emamekhoo says that interested patients should talk to their oncologists about the possibility of moving to telehealth, and whether it makes sense for their specific situation. Patients can always try it and switch back to in-person visits, if they prefer.
Additionally, UW will also soon upgrade to a new video platform, which is integrated into MyChart and promises to streamline the experience even further.
Going forward, Emamekhoo sees more and more potential for how telehealth could be used. For instance, a patient seeking a second opinion about a cancer diagnosis, or a consultation about participating in a clinical trial, could all be done through telehealth. This could potentially speed up decisions about cancer care and treatment, and when it comes to this disease, every moment counts.
Ultimately, Emamekhoo believes telehealth at UW Carbone will not only stick around, but keep evolving and adapting to patients’ needs as they arise.
“In some ways, the past year was very informative because we learned how much we can change and how quickly we can adapt in a short period of time, if we have to,” Emamekhoo said. “I’m also hoping that with these positive changes we’ve made in the last year, we will have a better chance of providing care to more patients through this telehealth platform in the future.”
Five Tips for the Best Possible Telehealth Appointment
Test your equipment ahead of time. Make sure your webcam, microphone and speakers are turned on. You’ll also want to make sure your device is charged, and connected to the internet.
Instead of a smartphone, consider using a device with a larger screen, such as a tablet or a laptop. You will have an easier time reading any scan or test results that your oncologist may share with you.
Earbuds or headphones are never a bad idea. Using them will cut down on background noise and ensure that you are able to clearly hear what your oncologist is saying. Wired headphones are recommended, but if you must use wireless headphones, make sure they are charged ahead of time.
Position your webcam at eye level, so that you can effectively look eye-to-eye with your doctor. If you’re using a smartphone or tablet, consider propping up the device on a stable surface, as opposed to holding it.
Your oncologist will also want to visually assess your condition, so make sure to sit in a well-lit area.