Regional Oncology Research Center (Digital Tools and Interventions)

Johns Hopkins University, Baltimore MD

Investigators

Linked publications, trials & patents

Abstract

❖ PROJECT SUMMARY This application is being submitted in response to the NOSI NOT-CA-23-041.The increasing use of digital health tools and interventions such as telehealth has resulted in a new era of patient-centered cancer care. Such care moves beyond the traditional in-person models to real-time and dynamic assessments and interventions enabled by telehealth and other digital health tools. The COVID-19 pandemic has also resulted in an unprecedented surge in technology-enabled patient-provider interactions. However, among cancer patients, sociodemographic disparities in telehealth utilization exist, which result in adverse health outcomes. Additionally, minoritized cancer patients report lower satisfaction with patient-provider communication during telehealth visits. As we transition through the COVID- 19 era, telehealth continues to be one of the modes of care delivery. Thus, models for integrating telehealth with traditional care processes become increasingly important, and an assessment of the effects of telehealth on patient- provider communication and health outcomes will be particularly valuable. Our proposed project addresses the hurdles in this process through the application of informatics, health services research, and stakeholder-engaged research. We propose to create a database of healthcare data and publicly available data to assess the effect of telehealth on patient-provider communication and outcomes of cancer care as well as to evaluate how the individual, interpersonal, community, and/or societal levels influence the effect of telehealth on patient-provider communication and resulting cancer-related health outcomes. This project will be undertaken by an experienced interdisciplinary team of investigators with many pre-existing resources. Many synergies will be gained by coordinating this supplement with previous efforts whereby our team developed and piloted different strategies to assess the outcomes of telehealth care across different patient populations. This oncology-focused supplement leverages data from our P30 center to advance cancer research and equity. The first aim of this project will be to apply objective and evidence- based outcome measures to assess the effect of telehealth on patient-provider communication across the cancer control continuum. Thus, we will perform an environmental scan and develop a large database containing such measures by using real-time data from electronic health records, claims, and patient surveys/reports. We will then examine characteristics of patient-provider communications via telehealth in terms of the patient population, phase of the cancer care continuum, type of telehealth approach, and intervention, and assess the effect of telehealth visits on cancer-related health outcomes and explore characteristics of the patient-provider communications that mediate better cancer-related health outcomes. The second aim will be to perform a comprehensive assessment of how individual, interpersonal, community, and societal factors influence the effect of telehealth on patient-provider communication and cancer-related health outcomes. Therefore, we will link real-time patient- and community-level data on individual, interpersonal, community, and/or societal characteristics and examine how such factors moderate the effect of telehealth on patient-provider communication, and on cancer-related health outcomes.