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CLL Monthly MinutesLeukemia

Using Telemedicine to Protect Vulnerable Patients and Provide Access to Care During COVID-19

The use of telemedicine has shown rapid growth over the course of the pandemic, with some experts suggesting that it is here to stay.
Web Exclusives – May 17, 2021

The ongoing COVID-19 pandemic has forced many changes on people’s lives. Social distancing, wearing a protective mask outside, and working from home have become the new normal as we try to contain the virus’s spread and protect society’s most vulnerable individuals.1

Patients with cancer, including those with hematologic cancers such as chronic lymphocytic leukemia (CLL), represent 1 group of people at risk of developing severe complications from COVID-19.1,2 Like most cancers, CLL can disrupt the individual’s ability to fight off infections, including the virus that causes COVID-19.2 In addition, cancer treatments can further impair the patient’s immune system, making them susceptible to infectious disease.2

To protect these patients, the Centers for Disease Control and Prevention issued guidance in early 2020 recommending that healthcare facilities and providers offer their services virtually, where possible.3 Unsurprisingly, recent data show that making the switch to telemedicine has seen wide adoption throughout the healthcare system. Between November 2019 (just prior to the pandemic) and November 2020, telehealth claims rose an astounding 3000%.4 Likewise, some CLL clinics report having as many as 40% of their patients participating in telemedicine visits, although that percentage changes depending on the number of COVID-19 cases.5

Telemedicine generally includes a mixture of telephone calls and video conferencing, although the actual method can vary state by state, and even provider to provider.6 It is important to note that the increased use of telemedicine has not completely replaced in-person visits, and most patients with CLL will need to follow up with a physical exam at some point.5 Some doctors have also commented that the doctor–patient relationship is different in person as opposed to over a video or phone, so they are often deferring to patient preference when it comes to choosing a virtual or in-person visit.5

Although telemedicine has shown great promise and has been generally well-accepted by patients and clinicians, it still has certain limitations.3 For example, some patients may have limited access to the Internet or connected devices like smartphones, tablets, or computers. Others may simply lack familiarity with using technology.3

Despite these challenges, experts expect that some proportion of patients will continue using telemedicine for as long as COVID-19 remains an active threat.5 Others even predict that, now that the systems and policies have been put in place, telemedicine may continue to serve as an important way of delivering and accessing care even after the pandemic has subsided.3


References

  1. Loguidice CT. COVID-19 pandemic restructures care in CLL. Published January 12, 2021. www.onclive.com/view/covid-19-pandemic-restructures-care-in-cll. Accessed April 18, 2021.
  2. Rossi D, Shadman M, Condoluci A, et al. How we manage patients with chronic lymphocytic leukemia during the SARS-CoV-2 pandemic. Hemasphere. 2020;4:e432.
  3. Koonin LM, Hoots B, Tsang CA, et al. Trends in the use of telehealth during the emergence of the COVID-19 pandemic - United States, January-March 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1595-1599.
  4. FAIR Health. Telehealth claim lines increase 2,938 percent nationally when comparing November 2019 to November 2020. Published February 2, 2021. www.prnewswire.com/news-releases/telehealth-claim-lines-increase-2-938-percent-nationally-when-comparing-november-2019-to-november-2020--301220192.html. Accessed April 18, 2021.
  5. Skarbnik AP, Coombs CC, Brander DM. CLL patient management during COVID-19 and telehealth. Published January 8, 2021. www.onclive.com/view/cll-patient-management-during-covid-19-and-telehealth. Accessed April 18, 2021.
  6. Kittai AS. CancerCare Connect Education Workshop: update on chronic lymphocytic leukemia (CLL). https://edge.media-server.com/mmc/p/vngzdx5x. Accessed April 18, 2021.

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Last modified: May 17, 2021

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