Rapid Scaling Up of Telehealth Treatment for Tobacco-Dependent Cancer Patients During the COVID-19 O
Tuesday, January 19, 2021
Posted by: Natalia Gromov
Kotsen
C, Dilip D, Carter-Harris L, O'Brien M, Whitlock CW, de Leon-Sanchez S, Ostroff
JS.
Rapid Scaling Up of
Telehealth Treatment for Tobacco-Dependent Cancer Patients During the COVID-19
Outbreak in New York City.
Telemed J E Health. 2021 Jan;27(1):20-29. doi: 10.1089/tmj.2020.0194. Epub 2020
Jul 9. PMID: 32649266.
Background.
The (COVID-19) pandemic resulted in sudden disruption of routine clinical care
necessitating rapid transformation to maintain clinical care while safely
reducing virus contagion.
Introduction.
Memorial Sloan Kettering (MSK) experienced a rapid evolution from delivery of
in-person cessation counseling services to virtual telehealth treatments for
our tobacco-dependent cancer patients.
Aim. To
examine the effect of rapid scaling of tobacco treatment telehealth on patient
engagement, as measured by attendance rates for in-person counseling visits
versus remote telehealth counseling visits. We also describe the patient,
clinician, and health care system challenges encountered in rapid expansion of
individual and group tobacco telehealth services.
Methods.
Data collected from the electronic medical record during the first 4 months of
the COVID-19 pandemic were examined for tobacco treatment counseling.
Results.
From January 1, 2020 to March 30, 2020, markedly improved patient engagement was
observed in ambulatory tobacco treatment services with greater attendance at
scheduled telehealth visits than in-person visits, 75% versus 60.3%, odds ratio
1.84 (confidence interval: 1.26-2.71; p < 0.001). In addition, bedside
hospital counseling visits were transformed into inpatient telephone visits
with high levels of sustained patient engagement. Lastly, group telehealth
services were launched rapidly to increase capacity and provide greater
psychosocial support for cancer patients struggling with tobacco dependence.
Discussion.
Clinical, Information Technology (IT), and hospital system barriers were
successfully addressed for most cancer patients seeking individual telehealth
treatment. Group telehealth services were found to be feasible and acceptable.
Conclusions.
MSK's rapid leap into virtual care delivery mitigated disruption of tobacco
treatment services and demonstrated strong feasibility and acceptance for
managing complex tobacco-dependent patients.
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