e13613 Background: Prior to COVID-19, there were few telehealth services offered in the oncology specialty area. During the pandemic, we at a national cancer center rapidly scaled our oncology telehealth program to meet the needs of our patients. At the peak of the pandemic, telehealth initially served as a risk-mitigation strategy providing continued care to our patients while socially distancing, yet additionally, we have embedded necessary processes in place to create a sustained a telehealth oncology program that encompasses a hybrid model including face to face visits augmented with telehealth visits, where appropriate. Here we describe the key telehealth program features that have enabled a national cancer center to evolve into a hybrid model of oncology care across its five geographically distinct hospitals. Methods: Transitioning into a sustainable hybrid telehealth model of care involves a foundation of clinical leadership and partnerships among multiple departments. The telehealth oncology program leaders collaborate with the operations, technology, finance, clinical care teams, and governance council to implement telehealth growth initiatives and nimbly troubleshoot and ameliorate issues. A concierge service provides telehealth readiness checks to ensure timely resolution of issues. Workflows are followed to standardize processes. Telehealth use-cases ensure patients who need on-site services keep their in-person appointments, allowing telehealth visits for symptom management to enhance patient outcomes. A provider education session includes training on telehealth technology and “webside manner” training to ensure we preserve the personal touch with our patients in each telehealth encounter. Program data is regularly collected and reviewed to track the program’s success and opportunities for improvement. Results: After the initial peak of telehealth visits driven by the COVID pandemic, we continue to see a sustained 10-fold increase in service volume versus Jan/Feb 2020. There were 25,328 total telehealth visits from Mar. 2020-Jan. 2021, 75 clinical trial visits between July-Dec. 2020, and 848 readiness check escalations from Nov. 2020-Dec. 2021. Service lines expanded from 2 to 33, including growing rural health partnerships and a home chemotherapy infusion model. Use-cases expanded to bridge to on-site care, rapid initial visits, preop/postop checks, symptom management, and surveillance. Press Ganey patient satisfaction rates are as high as 92% and 90% of providers reported overall satisfaction with the telehealth consultations. Conclusions: Our key program features have enabled the growth and success of our enterprise tele-oncology program. One of the most promising indicators of success is the positive provider and patient satisfaction rates. Telehealth provides an effective means to provide a bridge to onsite cancer care even for our complex oncology patients.
Neoplasm of the spinal cord: Implications for clinical care to improve symptom management and functionality
