Flexibility and Adaption Key for Future-Proofing Cancer Care Against Pandemics

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 panel 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.”

Flexibility During COVID-19

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, he said, compensated for by a 25% uptick in telemedicine visits. “We went back to normal levels by the third quarter of the pandemic,” said Dr Grubbs. “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.

“The pandemic forced 10 years of innovation into 6 weeks,” said Dr Klein, such as forcing providers to interact differently. 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,” he 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, noting broadband issues in rural areas, which may actually act to worsen disparities in cancer care, he warned.

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

Quick Adaptation of Cancer Care During COVID-19

Increased investment in omnichannel capability, leading to enhanced patient support services, resulted from 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 expected. 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. A lot of clinical trial enrollment starts in the community, commented a member of the audience.

The ability to learn how to deliver drugs at alternate sites of care, and initiation of home infusions, were 2 positives from the pandemic, said Ms Angello. “We need to continue to work on that,” she said.

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