With ongoing concerns regarding the effects of coronavirus disease 2019 (COVID-19) on the health care system, at the virtual Community Oncology Conference 2020, hosted by the Community Oncology Alliance (COA), an expert panel discussed how COVID-19 is changing the future of community oncology.

Moderated by Ted Okon, MBA, executive director, COA, the panel consisted of 4 leaders in the field of oncology, including Christian Downs, JD, MHA, executive director, Association of Community Cancer Centers; Ben Jones, vice president, Government Relations, The US Oncology Network; Deborah Kamin, RN, PhD, vice president, Policy & Advocacy, American Society of Clinical Oncology; and Brad Tallamy, senior director, Government Affairs, AmerisourceBergen.

Of particular importance highlighted by the panel during the COVID-19 pandemic is telehealth, which is a mode of care that has some key benefits and disadvantages when treating patients. Although telehealth had been an area of developmental interest for years, the pandemic has provided the industry with a strong push to advance this field.

“Telehealth offers an incredible opportunity for patients and providers. For patients, it’s a ‘no brainer,’ as it helps patients interact with any provider while at home, especially for those who are immuno-compromised and for others who are social distancing during COVID-19. I absolutely expect patients to take advantage of telehealth now and to expect that service beyond the pandemic,” Tallamy said during the panel.

However, the panelists agreed that telehealth will not be able to take the place entirely of an in-person visit. The importance of the “human touch,” especially within the field of community oncology, will remain a necessity going forward, according to the panel.

In this regard, the adoption of telehealth services in rural areas faces some particular difficulties due to a lack of consistent internet access and resources that would make telehealth viable for patients in these areas.

However, panelists raised the point that the existence of this issue is a contradiction to one of the initial impetus to develop further telehealth services, as patients’ difficulty to access services in rural areas demonstrated to providers that telehealth would be of particular use in these neighborhoods. This contradiction leaves some unanswered questions regarding the appropriate way forward for telehealth services in rural communities, which will remain an area of focus in the field into the future, according to the panel.

Yet, telehealth remains a key area of development during COVID-19 that will last in focus post-pandemic, since it provides a patient-centric perspective that fits the service focus of community oncology as a field.

“Telehealth services provide a good opportunity for community oncology, as community oncology has been the most patient-centric site of care. If any site of care can adapt to telehealth opportunities and enhance that patient-centric practice, it’s going to be community oncology,” Tallamy explained.

The panelists also discussed the effects of COVID-19 on the rising focus around home infusion for chemotherapy, cancer immunotherapy, and cancer treatment supportive drugs. COA recently released a statement regarding its position on home infusion, stating that it is fundamentally opposed to it due to concerns regarding the safety of patients. One of the key concerns with home infusion is the lack of access to teams of providers, additional drugs, tools, or equipment in case patients experience adverse reactions, which can not only be sudden and severe, but also life-threatening.

With much of the public in their homes during the COVID-19 pandemic, the panelists discussed how home infusion has risen in focus as a potential method for treatment. Yet it remains clear that, although telehealth and home care opportunities may be viable for certain aspects of oncology care, home infusion is not one of them, according to the panel.

Finally, the panelists addressed some key points regarding upcoming elections this year and its effect on rhetoric regarding health care in the country, especially in regard to drug pricing reform. The panelists acknowledged that whomever is elected will be entering 2021 with an enormous bill from COVID-19 funding to address, which will raise some pressing questions about the economic status not only of individuals in the United States, but of the future of the country as a whole.

REFERENCES
  1. Downs CG, Jones B, Kamin D, et al. Legislative Update From Capitol Hill: Cancer Politics & Policy in Washington, DC. In: Community Oncology Conference 2020; April 23-24, 2020.
  2. COA’s Position Statement on Home Infusion [news release]. Washington, DC: Community Oncology Alliance; April 9, 2020. communityoncology.org/coas-position-statement-on-home-infusion/. Accessed April 10, 2020.