Cancer treatment delayed in Australia – but telehealth may help

Medical News: “Emerging data show that cancer diagnostic and treatment delays due to COVID-19 priorities may lead to a substantial increase in the number of avoidable cancer deaths”, said Alison Verhoeven, Chief Executive of the Australian Healthcare and Hospitals Association (AHHA).

Numerous cancer care changes have been recommended and implemented to variable degrees. These include modification of treatment pathways, postponement of clinical trials, and delay in timely diagnosis, including suspension of screening programs. These changes were implemented to protect patients with malignant cancers who are considered to be a higher risk group for contracting COVID-19.

Ms Verhoeven was commenting on a Perspectives Brief published on 20 August 2020 by the AHHA’s Deeble Institute for Health Policy Research, Moving towards value-based, patient-centred telehealth to support cancer care, by a Perth-based research team from the University of Western Australia and Notre Dame University.

“On the face of it the delays appear to be a damned if you do, damned if you don’t situation,” said co-author Professor Christobel Saunders (University of WA).

“But we feel that effective use of telehealth can reduce these adverse outcomes and close some gaps in patient access to care.

“It will take some detailed planning and thinking through—but after analysing all the available evidence we think a telehealth service model for cancer care that integrates clinical and patient-reported outcomes appears to be a way forward that supports both patient needs and the needs of health professionals.

“It obviously cannot replace all face-to-face contact, but for many aspects of care it can be an acceptable alternative that will contribute to overall outcomes that are as good as, and maybe better than, a regime based completely on face-to-face contact,” Professor Saunders said.

Ms Verhoeven said the brief highlighted such a regime could offer better value to the health system as a whole, as well as better outcomes through innovative use of technology.

“For example, routine collection of patient-reported outcomes using electronic patient portals or smartphone applications could highlight problems that might not be apparent during both face-to-face and non-face-to-face discussions between patients and healthcare professionals.

“The COVID-19 pandemic has changed the landscape of our healthcare system, tested political and ethical boundaries, and necessitated quick implementation of policies and practices that in ordinary times would have been unimaginable or would have taken many years to implement,” Ms Verhoeven said.

“The significant uptake of telehealth across primary and secondary care for people of all ages and different health conditions, is a leading example.

“As our paper shows, there is also a need for a new model of telehealth service for cancer.

“It must necessarily align the clinical needs of patients, the expectations of healthcare professionals and fair funding arrangements.

“Almost by definition the care delivered by this model should be high value and patient-centred.”