Tele-oncology is the delivery of cancer services via telehealth technologies.Tele-oncology is used for provider-to-provider collaboration, patient consults,education and engagement, and ongoing monitoring and coordination.

Telehealth is commonly used in cancer care to expand access to specialtycare, like genetic counseling services and virtual tumor boards.

Tele-oncology applications

• Genetic counseling
• Tumor boards
• Symptom management
• Survivorship
• Nutrition counseling
• Support groups
• Subspecialist consults (e.g., onco-fertility specialist, onco-psychiatric counseling)
• Patient-provider consults
• Provider-to-provider consults
• Biometric monitoring
• Clinical trial follow-up visits
• Follow-up patient visits
• Distress screening
• Post-discharge monitoring
• Palliative care

As oncology faces rising volumes and workforce shortages, particularly in ruralareas, telehealth can help expand access and increase capacity. Only 7% of alloncologists practice in rural areas. This access problem is even worse forpatients seeking subspecialty care, with only 30 specialists per 100,000 peoplein rural America.

Although adoption of telehealth in cancer care lagged behind other specialties,tele-oncology adoption rose significantly during Covid-19, as organizations wereforced to stand up virtual programs in response to the closure of in-personservices. Utilization of tele-oncology increased from 17% in 2019 to 80% in2020. Moving forward, more organizations expect to use telehealth to distributeconstrained resources across systems and expand patient access.

Benefits of tele-oncology

Extends provider capacity

• Expands subspecialists’ reach to rural and underserved populations
• Reduces provider travel time to satellites
• Improves practice-level operational efficiencies

Improves patient access to care

• Increases access to subspecialty services and remote second opinions
• Offers additional support to patients, such as online support groups
• Maximizes patient convenience by bringing care closer to home

Improves care outcomes

• Enables coordination of multidisciplinary team-based care
• Enhances patient monitoring and treatment adherence through online education and RPM
• Drives patient engagement to better manage symptoms

Most tele-oncology visits are a combination of real-time and store-and-forwardtechnologies. Real-time virtual consults are used to connect patients to primaryand specialty providers as well as to connect providers to other providers.Increased collaboration between providers and patients is beneficial for oncologypatients, many of whom require chronic care management and behavioral healthsupport in addition to their cancer care. Store-and-forward technologies are usedto exchange medical information between providers and patients. The exchangeof information helps patients access treatment and manage their symptoms toimprove their quality of life.

Reimbursement

In the past, widespread adoption of tele-oncology was limited by reimbursementand regulatory hurdles, such as physician cross-state licensure restrictions andlimitations on where care is delivered and received. With temporary federalrelaxations of telehealth regulations amid the Covid-19 pandemic, adoption oftele-oncology increased significantly to ensure patients had access to care.

Payers have begun to reconsider the value of telehealth in response to theCovid-19 pandemic. While there aren’t cancer-specific telehealth billing codes,oncology programs can benefit from expanded reimbursement for generaltelehealth services.

• Define the scope of your tele-oncology program to fit into yourexisting strategy. Every telehealth program should address aspecific need and target patients who would benefit most fromthe convenience of telehealth.
• Determine how tele-oncology will increase care coordination tostreamline care across specialty and primary care.
• Discuss how you will define success of your tele-oncologyprogram and which metrics you need to track.

Compared to other specialties, telehealth has been underutilized by oncologyprograms. Now that Covid-19 has forced many oncology programs to adopt andexperiment with telehealth services, consider how to sustain your tele-oncologyprogram’s progress to benefit patients and providers.