Levine Oren Hannun, McGillion Michael, Levine Mark
Department of Oncology, McMaster University, Hamilton, ON, Canada.
Hamilton Health Sciences - Juravinski Cancer Centre, Hamilton, ON, Canada.
JMIR Cancer. 2020 Nov 24;6(2):e24222. doi: 10.2196/24222.
The interplay of virtual care and cancer care in the context of the COVID-19 pandemic is unique and unprecedented. Patients with cancer are at increased risk of SARS-CoV-2 infection and have worse outcomes than patients with COVID-19 who do not have cancer. Virtual care has been introduced quickly and extemporaneously in cancer treatment centers worldwide to maintain COVID-19-free zones. The outbreak of COVID-19 in a cancer center could have devastating consequences. The virtual care intervention that was first used in our cancer center, as well as many others, was a landline telephone in an office or clinic that connected a clinician with a patient. There is a lack of virtual care evaluation from the perspectives of patients and oncology health care providers. A number of factors for assessing oncology care delivered through a virtual care intervention have been described, including patient rapport, frailty, delicate conversations, team-based care, resident education, patient safety, technical effectiveness, privacy, operational effectiveness, and resource utilization. These factors are organized according to the National Quality Forum framework for the assessment of telehealth in oncology. This includes the following 4 domains of assessing outcomes: experience, access to care, effectiveness, and financial impact or cost. In terms of virtual care and oncology, the pandemic has opened the door to change. The lessons learned during the initial period of the pandemic have given rise to opportunities for the evolution of long-term virtual care. The opportunity to evaluate and improve virtual care should be seized upon.
在新冠疫情背景下，虚拟医疗与癌症护理之间的相互作用是独特且前所未有的。癌症患者感染新冠病毒的风险增加，且与未患癌症的新冠患者相比，预后更差。全球癌症治疗中心迅速且临时引入了虚拟医疗，以维持无新冠区域。癌症中心爆发新冠疫情可能会产生毁灭性后果。我们癌症中心以及许多其他中心最初使用的虚拟医疗干预措施是办公室或诊所里的一部固定电话，用于连接临床医生和患者。目前缺乏从患者和肿瘤医疗服务提供者角度对虚拟医疗的评估。已经描述了一些评估通过虚拟医疗干预提供的肿瘤护理的因素，包括患者融洽关系、虚弱状况、微妙对话、团队式护理、住院医生教育、患者安全、技术有效性、隐私、运营有效性和资源利用。这些因素是根据美国国家质量论坛评估肿瘤学远程医疗的框架进行组织的。这包括评估结果的以下4个领域：体验、获得护理的机会、有效性以及财务影响或成本。就虚拟医疗和肿瘤学而言，疫情为变革打开了大门。疫情初期吸取的经验教训为长期虚拟医疗的发展带来了机遇。应该抓住评估和改进虚拟医疗的机会。
