Many rural areas identify with many barriers in their community, such as transportation, technology access, human factors, and the design of the health care model.
There are a lot of potential virtual health options for cancer care providers to keep up that provide solutions for the COVID-19 pandemic. According to Johanna Garzon, MHA, HBAT, director of Central Care Cancer Center in Missouri, during a session at the Association of Community Cancer Centers (ACCC) 47th Annual Meeting and Cancer Center Business Summit, although solutions are available, oncology teams have to keep the momentum going while the government keeps up with their promised goals to support telehealth in rural communities.
Many rural areas, like the region serviced by Central Care Cancer Center, identify with many barriers in their community, such as transportation, technology access, human factors, and the design of the health care model.
A main issue that Garzon highlighted in her session was having the appropriate technology to help the center’s patients.
“This is a barrier in telehealth because there is no consistency among the devices we can use,” Garzon said.
She further elaborated about the many different options, such as Zoom, FaceTime, and phone calls, which leads to staff and patient miscommunications or unfamiliarity of a program.
In terms of implementing the right health care model, Garzon mentioned how having the right leadership team is essential, including an oncology liaison and participation within and outside of the parties.
“Change is hard because there are other people who need to learn, schedule, and explain how it works, but that’s why we have to reach out to hospitals, communities for a coordinated effort,” Garzon added.
Following the right team in telehealth, the government policies are very important to Garzon, such as a license for the doctor, reimbursement, and patients who need to be on site versus those who do not. After policies, information technology, like security and infrastructure, should follow for a successful onco-telemedicine team.
A barrier that Garzon said is crucial for implementing telehealth in a rural community, like her own in Garden City, Kansas, is educating the team, including how things work for the staff and the patient. If the staff cannot explain a topic like connecting to an iPad or iPhone, then there will be more communication issues when speaking with a patient.
A solution to this problem is having an evaluation of the programs, and what patients and staff prefer to use for their communication route.
“Feedback of our telemedicine services from the staff and patients, such as the challenges and the impact it has on the organization, is great to know for what we can do to move forward and improve,” Garzon said.
Comparing pre-COVID times to post-COVID times (which she classified as March 2020 versus September 2020), there have been adjustments to the Central Care Cancer Center’s health care model. For example, pre-COVID-19 saw the center having approximately 5 to 7 locations, with follow-up in their small town being difficult, since only 5% of the locations offered telehealth services. With the adjustments rooting from post-COVID-19, there are now approximately 7 to 10 locations, with second opinions and follow-up visits being easier, as 50% to 60% of the offices have implemented telemedicine options for their patients.
Even with these achievements, Garzon is hoping that the momentum from the rural cities and the government will continue to grow as the months go on.
“We are still going to have challenges, such as educating the staff and ourselves, and we don’t have consistency between estates or technology,” Garzon said. “We also need to work on getting to know patients and being more creative on how we can follow up with them and educate them, so there is room for improvement.”
Garzon, J. Virtual Solutions: Oncology Telemedicine for Rural Communities. Presented at: ACCC 47th Annual Meeting & Cancer Center Business Summit; virtual: March 2, 2021.