Oncology practices detail quick switch to telehealth, barriers to using technology permanently

Oncology practices that are still treating vulnerable patients have increasingly turned to telehealth amid uncertainty caused by COVID-19.

Some oncologists shared their experiences adopting telehealth during a virtual conference Thursday held by the Community Oncology Alliance. Oncology practices are now figuring out how to permanently incorporate the technology, which comes with major questions about reimbursement and when to use it.

“We had the tools and technology that we never tapped into but it improved patient care in the ways that we couldn’t have imagined,” said Sibel Blau, M.D., medical director for Northwest Medical Specialties, an oncology group practice in Washington state, during the conference. “We are able to do a consultation and bring a patient’s family members from different parts of the country into the conversation.”

Oncologists shared how telehealth has not just improved the patient experience but also communication among practice leadership and staff.

“We have three clinical site locations and have Zoom meetings with all three sites at once,” said Anthony Scalzo, M.D., president of Hematology/Oncology Associates of Central New York. “Getting your employees accurate information in real-time was critical.”

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Practices had to quickly prop up telehealth technology as COVID-19 spread across the U.S., with most turning to cloud-based platforms, said Nick Recker, president of Path Forward, an IT services group that has helped oncology practices set up telehealth.

Over a two-week period in March, there were “millions all pivoting to a virtual presence and in many cases using the same platforms,” he added.

But with the quick adoption of telehealth comes major questions on what will happen next, especially with reimbursement.

The Centers for Medicare & Medicaid Services gave flexibility to providers to use telehealth, removing a major regulatory barrier to the technology. But a critical question mark is how commercial payers are going to respond to the widespread use and how much providers will get paid.

“Private payers are acknowledging telehealth,” said Steve D’Amato, CEO of New England Cancer Specialists. “I don’t see that as a problem right now, but we will know more as we submit claims and look at what we get paid.”

RELATED: Half of physicians now using telehealth as COVID-19 changes practice operations

Payment is not the only issue oncologists could face in keeping telehealth around.

Practices need to start building requirements about how to use telehealth today and in the future—specifically, conditions for a patient to be seen in person or via telehealth, Recker said during a separate session at the conference.

“I also highly recommend surveying patients,” he said. “This experience is still very fresh for them. What do they like and not like about telehealth and challenges they experience?”

Practices will also need to reconfigure their networks to boost more bandwidth to enable streaming and audio technology.

Recker advised practices to not sign any long-term contracts for telehealth services, as vendors will start to develop products that can incorporate telehealth into the electronic health record.

“For the next six months, unless you have a deficiency, whatever you implemented stay with it for now,” he said.