Telehealth and hospital-at-home in oncology
Video visits, remote monitoring and home delivery of some cancer treatments expanded massively during COVID-19 and have stayed; they reduce travel burden, especially for rural patients, without evidence of worse outcomes.
Telehealth use in oncology rose from ~1% to ~50% of visits at the 2020 peak and settled around 10-20%. Evidence: REACH PC (JAMA 2024) showed video palliative care equal to in-person; teleoncology models (Australia's Townsville, US rural networks) deliver chemotherapy supervision remotely; home infusion of some agents (subcutaneous daratumumab, pembrolizumab, trastuzumab-pertuzumab) and oral therapies with remote monitoring are growing; 'hospital-at-home' for febrile neutropenia and CAR-T monitoring is being piloted. Decentralised clinical trials use telehealth to broaden enrolment. Limits: broadband and digital literacy (the digital divide widens disparities), licensure across state lines, reimbursement parity, and the need for physical examination and imaging.
How it works
Substitute synchronous video or asynchronous digital contact and remote monitoring for in-person visits where physical assessment is not required, and move low-risk treatment and monitoring into the home.
- Reduces travel time and cost for patients
- Equivalent outcomes for palliative care and follow-up visits
- Expands trial and specialist access to rural areas
- Digital divide
- Regulatory and reimbursement uncertainty
- Not suitable for examination-dependent visits or complex toxicity
Latest papers
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