Increasing equitable access to telehealth oncology care in the COVID‐19 National Emergency: Creation of a telehealth task force
Abstract Introduction Telehealth (TH) utilization in cancer care prior to COVID‐19 was variable. Research highlights disparities in access determined by socioeconomic factors including education, income, race, and age. In response to COVID‐19 and these disparities, we assessed the impact of a person...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-02-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.5176 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846157636645421056 |
|---|---|
| author | Brooke Worster Lauren Waldman Gregory Garber Tingting Zhan AnaMaria Lopez Olivia Trachtenberg Nathan Handley Kristin L. Rising Valerie Csik Amy Leader |
| author_facet | Brooke Worster Lauren Waldman Gregory Garber Tingting Zhan AnaMaria Lopez Olivia Trachtenberg Nathan Handley Kristin L. Rising Valerie Csik Amy Leader |
| author_sort | Brooke Worster |
| collection | DOAJ |
| description | Abstract Introduction Telehealth (TH) utilization in cancer care prior to COVID‐19 was variable. Research highlights disparities in access determined by socioeconomic factors including education, income, race, and age. In response to COVID‐19 and these disparities, we assessed the impact of a personalized digital support structure, the Telehealth Task Force (TTF), to reduce disparities in TH. Methods We performed a retrospective review of cohorts between January 1, 2020 and August 30, 2020: Pre (TH use with basic telephone support), Intervention (TH access with TTF), and Post (TH access after TTF initiation and educational material dissemination). Data collected included successful TH access, health literacy (HL), and Area Deprivation Index, a ranking of neighborhoods by socioeconomic disadvantage (ADI). The data were analyzed in univariate ordinary least squares model and adjacent categories ratio model using statistical software R to understand the relationship between TTF, HL, ADI, and TH access. Results We included 555 patients from January 1, 2020 to August 30, 2020 (90 preintervention, 194 intervention, and 271 postintervention), excluding patients without ADI/HL. TTF support successfully engaged older, racially, and socioeconomically diverse patients in TH; ADI is significantly higher in the postintervention group vs. preintervention (mean difference = 7.66, 95% CI 1.00–4.32, p = 0.024) and more patients had low HL during intervention compared with preintervention (adjacent categories ratio = 0.62, 95% CI 0.41–0.93, p = 0.021). Discussion COVID‐19 created an immediate need for TH. Implementation of the TTF helped close the digital divide, increasing TH access for vulnerable patients. Attention to digital readiness can mitigate disparities in access to care. Future research should explore the implementation of widespread routine digital support initiatives. |
| format | Article |
| id | doaj-art-f87b7cd17f41451cb56dc6a9972e8bab |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-f87b7cd17f41451cb56dc6a9972e8bab2024-11-25T07:56:31ZengWileyCancer Medicine2045-76342023-02-011232842284910.1002/cam4.5176Increasing equitable access to telehealth oncology care in the COVID‐19 National Emergency: Creation of a telehealth task forceBrooke Worster0Lauren Waldman1Gregory Garber2Tingting Zhan3AnaMaria Lopez4Olivia Trachtenberg5Nathan Handley6Kristin L. Rising7Valerie Csik8Amy Leader9Sidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia Pennsylvania USASidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia Pennsylvania USASidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia Pennsylvania USADivision of Biostatistics, Department of Pharmacology & Experimental Therapeutics Thomas Jefferson University Philadelphia Pennsylvania USASidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia Pennsylvania USASidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia Pennsylvania USASidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia Pennsylvania USADepartment of Medical Oncology Thomas Jefferson University Philadelphia Pennsylvania USASidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia Pennsylvania USASidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia Pennsylvania USAAbstract Introduction Telehealth (TH) utilization in cancer care prior to COVID‐19 was variable. Research highlights disparities in access determined by socioeconomic factors including education, income, race, and age. In response to COVID‐19 and these disparities, we assessed the impact of a personalized digital support structure, the Telehealth Task Force (TTF), to reduce disparities in TH. Methods We performed a retrospective review of cohorts between January 1, 2020 and August 30, 2020: Pre (TH use with basic telephone support), Intervention (TH access with TTF), and Post (TH access after TTF initiation and educational material dissemination). Data collected included successful TH access, health literacy (HL), and Area Deprivation Index, a ranking of neighborhoods by socioeconomic disadvantage (ADI). The data were analyzed in univariate ordinary least squares model and adjacent categories ratio model using statistical software R to understand the relationship between TTF, HL, ADI, and TH access. Results We included 555 patients from January 1, 2020 to August 30, 2020 (90 preintervention, 194 intervention, and 271 postintervention), excluding patients without ADI/HL. TTF support successfully engaged older, racially, and socioeconomically diverse patients in TH; ADI is significantly higher in the postintervention group vs. preintervention (mean difference = 7.66, 95% CI 1.00–4.32, p = 0.024) and more patients had low HL during intervention compared with preintervention (adjacent categories ratio = 0.62, 95% CI 0.41–0.93, p = 0.021). Discussion COVID‐19 created an immediate need for TH. Implementation of the TTF helped close the digital divide, increasing TH access for vulnerable patients. Attention to digital readiness can mitigate disparities in access to care. Future research should explore the implementation of widespread routine digital support initiatives.https://doi.org/10.1002/cam4.5176clinical oncologyCOVID‐19 pandemichealthcare disparitieshealth literacyqualitative researchtelemedicine |
| spellingShingle | Brooke Worster Lauren Waldman Gregory Garber Tingting Zhan AnaMaria Lopez Olivia Trachtenberg Nathan Handley Kristin L. Rising Valerie Csik Amy Leader Increasing equitable access to telehealth oncology care in the COVID‐19 National Emergency: Creation of a telehealth task force Cancer Medicine clinical oncology COVID‐19 pandemic healthcare disparities health literacy qualitative research telemedicine |
| title | Increasing equitable access to telehealth oncology care in the COVID‐19 National Emergency: Creation of a telehealth task force |
| title_full | Increasing equitable access to telehealth oncology care in the COVID‐19 National Emergency: Creation of a telehealth task force |
| title_fullStr | Increasing equitable access to telehealth oncology care in the COVID‐19 National Emergency: Creation of a telehealth task force |
| title_full_unstemmed | Increasing equitable access to telehealth oncology care in the COVID‐19 National Emergency: Creation of a telehealth task force |
| title_short | Increasing equitable access to telehealth oncology care in the COVID‐19 National Emergency: Creation of a telehealth task force |
| title_sort | increasing equitable access to telehealth oncology care in the covid 19 national emergency creation of a telehealth task force |
| topic | clinical oncology COVID‐19 pandemic healthcare disparities health literacy qualitative research telemedicine |
| url | https://doi.org/10.1002/cam4.5176 |
| work_keys_str_mv | AT brookeworster increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce AT laurenwaldman increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce AT gregorygarber increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce AT tingtingzhan increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce AT anamarialopez increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce AT oliviatrachtenberg increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce AT nathanhandley increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce AT kristinlrising increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce AT valeriecsik increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce AT amyleader increasingequitableaccesstotelehealthoncologycareinthecovid19nationalemergencycreationofatelehealthtaskforce |