In this time of international emergency when COVID-19 is forcing country-wide shutdowns, cancer does not stop, and cancer patients need ongoing treatment and follow-up visits.
Recognizing the need to continue treatment for patients with cancer while limiting the spread of COVID-19, the Centers for Medicare & Medicaid Services (CMS) has broadened access to Medicare services outside the typical office visit setting for the duration of the COVID-19 emergency. With this temporary expansion of coverage, many physicians, nurse practitioners, and clinical social workers can now charge for telemedicine in the form of telehealth visits, involving the use of interactive audio and visual platforms. These visits can include virtual check-ins, eg, brief communication service via telephone or video calls; and e-visits, patient-doctor communication via online patient portals. Many other healthcare providers can also use this method: physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, registered dietitians, and nutrition professionals.
The new telemedicine policies have the flexibility to allow clinicians to evaluate patients who have audio-only phone systems, to accommodate low-income or elderly patients who may not have access to advanced technology. With this new telemedicine tool, oncologists can manage many of their patients’ needs outside of clinic and hospital environments, allowing them to avoid trips outside their shelter-in-place locations. CMS’ expansion of telehealth was welcomed by the Community Oncology Alliance, who have posted guidance on their website for community oncology practices during the COVID-19 emergency, which includes useful information on telemedicine.
Optimization and expansion of telemedicine will enable ongoing care to cancer patients while minimizing exposure risks during the COVID-19 pandemic.
High Altitude: Implementation or expansion of telemedicine may be important for large practices, to limit COVID-19 exposure and spread among patients and healthcare providers. The CMS has recently expanded their telehealth policies, allowing oncologists to offer telehealth, virtual check-ins, and e-visits to their patients. These new policies might allow for decreased traffic in busy oncology centers. Experts and healthcare policymakers will likely be monitoring this expanded use of telehealth and telemedicine during this period and might consider maintaining some of these policies after the pandemic-related restrictions have been lifted.
Ground Level: With the current state of emergency due to the COVID-19 pandemic, oncologists are facing new challenges with monitoring and treating their patients, many of whom are being advised to stay home because of the risk of infection. Thanks to the new CMS expansion of telemedicine polices, oncologists can now replace some face-to face visits with phone and/or video calls with their patients and obtain payment for these services. This new clinical policy fills an important need for patient management while minimizing unnecessary travel during the pandemic.