Abstract PO-037: SKCC medical oncology telehealth experience during Covid-19 pandemic: Lessons learned and operational changes to leverage telehealth to maintain patient access
Authors: Bhatia Avnish , Waldman Lauren , Garber Gregory , Sabonjian Megan , Hunt Melissa , Palidora Janene , Leader Amy , Worster Brooke 
Published: December 2020

Abstract
The purpose of this report is to share lessons learned at the Sidney Kimmel Cancer Center (SKCC) in response to the COVID-19 National Emergency, marked by expanding telehealth (TH) to decrease patient risk while maintaining access to care. TH utilization requires resources (smart phones/tablets, email, internet), and there are disparities in digital media access in our patient population. We learned from a digital literacy survey performed at the SKCC in 2018 that 30% of our patients used Android phones and &gt; 60% of patients accessed the internet from a PC. Our EHR was built to support a “nonpandemic” level of TH visits, which increased in a short span from 29 visits in January 2020 to 1,700 visits in April 2020. Pre-COVID, the Jefferson TH office had 5 support employees to assist patients with TH. Though some patients needed support, the TH team had a manageable caseload. During the first weeks of the pandemic, the EHR TH software was updated to accommodate increased demand, requiring PC/mobile device upgrades/setting changes, which posed a potential barrier to care. In response to increased TH demand and need for support, the SKCC launched an oncology-dedicated Telehealth Task Force (TTF) to address barriers to TH access. Examples of TTF’s targeted patient solutions include set-up and delivery of smartphones, creating email accounts, disseminating instructions for TH use, and real- time assistance during TH visits. Daily protocol for support staff across the SKCC adapted to accommodate the increase in TH visits. Phone room staff experienced increased volume of scheduling requests to change in-person visits to TH, from 165 rescheduled in March 2020 to 431 in April 2020, and established new scripting and triage protocol. Administrative staff now follows up telephonically for TH visits. Providers noted challenges in completing TH visits within predetermined appointment length due to technical delays and increased time needed for novice users. The nurse’s role in the care team was vital in reinforcing to patients the availability of TTF supports prior to their TH visits and communicating appointment delays to improve patient experience. Providers noted the need to document at the point of care as support staff rely on this to schedule testing/follow-up visits. Supportive resources for TH were quickly appreciated, such as access to forms for timely documentation of treatment consent. The SKCC experienced an exponential rise in TH use and made critical workflow adjustments as well as creating a dedicated TTF to maintain access to care for oncology patients during an uncertain public health crisis.
Citation Format: Avnish Bhatia, Lauren Waldman, Gregory Garber, Megan Sabonjian, Melissa Hunt, Janene Palidora, Amy Leader, Brooke Worster. SKCC medical oncology telehealth experience during Covid-19 pandemic: Lessons learned and operational changes to leverage telehealth to maintain patient access [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-037.