Senior woman on a video call with her doctor
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The National Cancer Institute recently announced a five-years grant of $5.7 million to fund the launch of four new cancer Telehealth Research Centers of Excellence (TRACE). The program, with support from the White House Cancer Moonshot, will seek to develop and test advanced methods of telehealth delivery for cancer care with a focus on promoting health equity.

The four institutions receiving funds under TRACE include Memorial Sloan Kettering Cancer Center, Northwestern University, New York University Grossman School of Medicine, and the Perelman School of Medicine at the University of Pennsylvania.

Already a growing trend before COVID-19, telehealth services have seen substantial increases in the past few years which have only been amplified by the pandemic amid the need for social distancing.

According to the TRACE website, “Research has shown that telehealth can improve healthcare access and quality, patient/provider communication, and health outcomes. Importantly, many aspects of cancer care can be delivered through telehealth, such as promotion of positive health behaviors and cancer screening, remote patient monitoring and management of symptoms during cancer treatment, and virtual survivorship follow-up care.”

Yet, while the application of telehealth is growing, the NCI notes that there continues to be a need to conduct large-scale research into its use, in diverse clinical settings, in order to optimize its use embed it as a viable mode of cancer caner delivery, as well as develop methods to identify and disseminate best practices for its use. One goal of increasing telehealth services is to address issues of healthcare equity.

Goals of the TRACE initiative include:

  • rapidly developing an evidence base of telehealth approaches to cancer care, spanning prevention to survivorship;
  • identifying and addressing disparities in access to and use of telehealth services for cancer-related care;
  • fostering innovations to improve cancer care delivery using new tools, research methods, and technologies; and
  • evaluating the changing policy and payment environment and its impact on delivery of telehealth for cancer care

One of the new centers of excellence will be the University of Pennsylvania (Penn) Telehealth Research Center in Cancer Care (Penn TRACE), based at the Penn Center for Cancer Care Innovation (PC3I) at the Abramson Cancer Center (ACC). At Penn the grant will fund the design and testing of new telehealth strategies across the lung cancer care continuum, from screening to molecular testing to survivorship, with an emphasis on lung cancer morbidity and mortality, health disparities, and the digital divides. It will also provide incentives for more research on telehealth’s impact on patient outcomes, patient-provider communication, and health care use.

“For patients undergoing screening or treatment for cancer, advances in telehealth propelled by the COVID-19 pandemic could be tremendously beneficial, yet telehealth strategies must address the digital divide so as not to also exacerbate known disparities in cancer outcomes,” Katharine Rendle, PhD, an assistant professor of Family Medicine and Community Health and deputy director at PC3I, one of three principal investigators at Penn. “We aim not only to ensure equal access to telehealth but also to use it in ways that reduce persistent barriers to care in order to transform how we deliver cancer care today.”

The core mission of Penn TRACE will be to create, test, and scale telehealth approaches aimed at improving outcomes and equity in lung cancer care. The researchers will embed rapid tests of telehealth approaches linked with clinical trials. The center’s main trial will compare the effectiveness of telehealth strategies to increase shared decision making for lung cancer screening using an adaptive design. A second trial will test a telehealth strategy for patients with advanced lung cancer to improve timely treatment recommendations through early integration of plasma-based comprehensive molecular testing.

“There has been a dramatic expansion in the use of telehealth in the past few years, creating a critical need to determine which telehealth methods work best, for whom, and under what conditions,” Justin Bekelman, MD, a professor of Radiation Oncology, Medicine, and Medical Ethics and Health Policy, and director of PC3I. “We are honored to be part of the Cancer Moonshot’s substantial investment in telehealth research, sharing Penn’s unique approach to designing and testing how telehealth can advance equitable cancer care.”

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