Three Key Areas to Manage in COVID-19 Telehealth Cancer Care Environment

The COVID-19 pandemic shifted medical operations to a primarily telehealth environment, requiring health care institutions to develop their virtual resources and reorganize operations.

During a panel discussion at the Hematology/Oncology Pharmacy Association 2021 virtual conference, Jennifer Thackray, BCPPS, BCPS, PharmD of Memorial Sloan Kettering Cancer Center and Zanette Kanani Bradley, PharmD of Children’s Hospital Colorado discussed how their organizations responded to the COVID-19 pandemic by shifting many of their day-to-day operations to a virtual setting.

The speakers highlighted 3 key areas most affected by the pandemic: coordination with service teams, communication with providers, and patient interactions.

Near the beginning of the pandemic, it was difficult to keep track of which providers were seeing which patients each day. Service team schedules varied and contact information was frequently rendered inaccurate by the shift away from in-office work.

“Identifying which provider to follow up with a non-clinic patient was particularly tough for us, because our [electronic medical record] did not let us know where the patient was being seen, because pediatric patients hadn’t been seen at regional sites or really had local labs before,” Thackray said.

By gaining access to the scheduling system maintained by the patient care coordinators, service team coordination became considerably easier. Thackray’s team also implemented daily huddles, a large increase in follow-up emails, and designating channels for urgent and non-urgent communication. This resulted in a more organized and reliable patient visit schedule, more transparent provider schedules and contact information, and efficient way to coordinate with multiple providers via secure chat.

“I also found that triaging the urgent versus the non-urgent methods of communication was important to figure out early on in the transition and was often done by trial and error,” Kanani Bradley said. “In addition, working a day ahead in terms of schedule so that any outstanding issues could be identified and resolved in advance was crucial in preventing delays of care and supporting my team.”

Communication with providers was also critical to manage. According to Kanani Bradley, the most effective strategy was to limit communication methods to 1 or 2 platforms, as well as setting clear boundaries between providers and the parents of pediatric patients, including out-of-office email with automatic replies for who to contact in the provider’s absence. Kanani Bradley refers to refining overall communication as a particular point of success.

“Secure chat, or secure text messaging, which was historically underutilized, became commonplace, and an easy way to communicate with individual providers or a group,” Kanani Bradley said. “It’s also less intrusive than a phone call, and much more efficient than running around clinic trying to find a provider.”

Patient interactions became vastly different during the pandemic, with questions surrounding how to coordinate patient contact and how to best provide pharmacy services virtually, including patient counseling, fielding drug information questions, medication reconciliation, and providing home medication sheets to families.

Kanani Bradley’s team found the most success by having the inpatient pharmacist alert families of future follow-up phone calls to be certain it was possible to reach them and utilizing an electronic patient portal to deliver documents to patients effectively in the new virtual environment.

“Feedback from caregivers and providers still found counseling to be valuable,” Kanani Bradley said. “It did not require in-person or even video to be beneficial. Support is offered, medication errors are caught, and ultimately, strong pharmacy services are being provided.”

REFERENCE

Zanette Kanani Bradley, Jennifer Thackray. Surviving in a Virtual World: A Panel Discussion. Presented at: HOPA Annual Conference 2021; April 15, 2021; Virtual.