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Experts Agree That Flexibility and Adaptability Are Essential for Future-Proofing Cancer Care Against Pandemics

TOP - January 2022 Vol 15, No 1 – Online Only

Enhanced flexibility in delivery, increased investment in digital capability, and quick adaptation to events were some of the positive impacts of the COVID-19 pandemic on cancer care.

“Radical events lead to radical change,” said Ira Klein, MD, MBA, FACP, Vice President, Medical Affairs and Payer Relations, Tempus Labs, New York City, who moderated a session on future-proofing cancer against pandemics at the 11th Annual Summit of the Association for Value-Based Cancer Care in 2021. “Radical change is not a bad thing when we need to fix broken elements of a system,” he noted.

Flexibility in Cancer Care

The need for flexibility in cancer care during the COVID-19 pandemic was variable across the country as hot spots emerged, said Stephen Grubbs, MD, FASCO, Vice President, Clinical Affairs, American Society of Clinical

Oncology. The pandemic necessitated quick adaptation with regard to infection control and to digital technology, which was exported across the entire industry. The resiliency among staff was apparent during this time, he said.

The delay in cancer diagnoses during the pandemic has been a real concern but also spurred the speed of innovation, Dr Grubbs believes. How best to overcome this barrier in the event of another pandemic must be addressed.

Increased Digital Capability

Practice visits dropped by approximately 25% during the first quarter of the pandemic, Dr Grubbs said, compensated for by a 25% uptick in telemedicine visits. “We went back to normal levels by the third quarter of the pandemic,” he stated. “Telemedicine has leveled off at about 5% of all visits.”

Telemedicine will continue to have an important role in the future of cancer care delivery, with the challenge to determine its niche in the level of use that patients and providers prefer.

Although telemedicine was a revolution, the importance of in-office visits will remain. “There’s a tangible aspect of touch and feel that you can’t get with telemedicine,” Dr Klein said.

Although routine follow-up visits were made easier and permitted rural access to expertise, not every patient has access to “good” telemedicine, said Dr Grubbs, pointing to broadband issues in rural areas, which may actually act to worsen disparities in care for some patients.

Continued reimbursement for telemedicine services will determine the degree to which this modality will be used in the future, Dr Grubbs said. The impact of telemedicine on care delivery at the local level must be assessed so as not to remove local care, he added.

Quick Adaptation of Cancer Care

Increased investment in omnichannel capability, leading to enhanced patient support services, was a result of the pandemic, said Deanna Angello, MBA, Head, Oncology Franchise Strategy and Key Accounts, Janssen Oncology, who suggested that this investment could bring more personalized care to patients and engage them in a more personal way.

When asked how advance warning of the pandemic would have better prepared the field of oncology, Dr Grubbs responded that infection control and availability of personal protective equipment would have been much better. Ms Angello said that the investment in building different digital capabilities would have occurred much sooner, as well as the breakdown of silo partners involved in cancer care delivery, including data providers, academia, and industry. She noted that “collaboration has been a highlight of the past 18 months,” as these partners addressed the need for sharing data.

Staff burnout worsened because of COVID-19, said Dr Grubbs, and will be a continuing challenge as shortages of staff in the oncology space are predicted. To this end, continued shifting of resources and investment into digital technology is expected, in the hopes of delivering the right expertise to the customer, said Ms Angello.

A pause in clinical research was an adverse consequence of the pandemic, but the breakdown of barriers to collaboration, such as data sharing, may act to reinvigorate research, believes Ms Angello. “Will we make up everything we lost? I can’t answer that,” she said.

“We learned how to make clinical trials much more flexible,” said Dr Grubbs, as more testing and consent was performed at remote centers.

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