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Telemedicine for Cancer Care in the Time of COVID-19

Educational Objective
To understand how telemedicine is being used to treat cancer during COVID-19
1 Credit CME

On March 30, 2020, the US Centers for Medicare & Medicaid Services (CMS) released an interim final rule that capped off a dizzying month of temporarily loosening regulations to give health care professionals maximum flexibility in responding to the coronavirus disease 2019 (COVID-19) pandemic.1 A primary goal of this regulatory flexibility, enabled by the President’s declaration of a national emergency and the declaration of the Secretary of the Department of Health and Human Services (HHS) of a public health emergency, is the promotion of virtual medicine by expanding coverage for telehealth services to Medicare beneficiaries. Telehealth may facilitate US citizens’ access to essential health benefits while respecting physical distancing, an essential disease spread mitigation strategy for COVID-19.2 With a vulnerable patient population, these changes have already had a widespread effect on the delivery of oncology services during the pandemic and may yet have unforeseen effects.3 We herein review the changes and consider their effects on quality of care.

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Article Information

Corresponding Author: Trevor J. Royce, MD, MS, MPH, Department of Radiation Oncology, University of North Carolina at Chapel Hill, 101 Manning Dr, CB 7512, Chapel Hill, NC 27599 (trevor_royce@med.unc.edu).

Published Online: July 16, 2020. doi:10.1001/jamaoncol.2020.2684

Conflict of Interest Disclosures: Dr Sanoff reports grants from Bayer. No other disclosures were reported.

References
1.
Medicare.gov. Telehealth Insurance Coverage. Accessed June 23, 2020. https://www.medicare.gov/coverage/telehealth
2.
Centers for Medicare and Medicaid Services. President Trump expands telehealth benefits for Medicare beneficiaries during COVID-19 outbreak. Accessed April 1, 2020. https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak
3.
Schrag  D , Hershman  DL , Basch  E .  Oncology practice during the COVID-19 pandemic.   JAMA. Published online April 13, 2020. doi:10.1001/jama.2020.6236Google Scholar
4.
Centers for Medicare and Medicaid Services. Trump administration makes sweeping regulatory changes to help U.S. healthcare system address COVID-19 patient surge. Accessed April 1, 2020. https://www.cms.gov/newsroom/press-releases/trump-administration-makes-sweeping-regulatory-changes-help-us-healthcare-system-address-covid-19
5.
Royce  T , Basch  E , Bekelman  JE .  Supervision requirements in the 2020 hospital outpatient prospective payment system: implication for cancer care in the United States.   JAMA Oncol. Published online April 9, 2020. doi:10.1001/jamaoncol.2020.0092Google Scholar
6.
Hollander  JE , Carr  BG .  Virtually perfect? telemedicine for Covid-19.   N Engl J Med. 2020;382(18):1679-1681. doi:10.1056/NEJMp2003539PubMedGoogle ScholarCrossref
7.
Tuckson  RV , Edmunds  M , Hodgkins  ML .  Telehealth.   N Engl J Med. 2017;377(16):1585-1592. doi:10.1056/NEJMsr1503323 PubMedGoogle ScholarCrossref
8.
Waterhouse  DM , Harvey  RD , Hurley  P ,  et al.  Early impact of COVID-19 on the conduct of oncology clinical trials and long-term opportunities for transformation: findings from an American Society of Clinical Oncology survey.   JCO Oncol Pract. Published online May 12, 2020. doi:10.1200/OP.20.00275PubMedGoogle Scholar
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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