@Article{info:doi/10.2196/66275,
author="Minvielle, Etienne
and Perez-Torrents, Joel
and Salma, Israa
and Aegerter, Philippe
and Ferrua, Marie
and Fert{\'e}, Charles
and Leleu, Henri
and Mathivon, Delphine
and Sicotte, Claude
and Di Palma, Mario
and Scott{\'e}, Florian",
title="The Effect of Nurse Navigators in Digital Remote Monitoring in Cancer Care: Case Study Using Structural Equation Modeling",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="28",
volume="27",
pages="e66275",
keywords="digital remote monitoring",
keywords="nurse navigators",
keywords="patient care",
keywords="oncology",
keywords="toxicity",
keywords="patient satisfaction",
keywords="hospitalization",
abstract="Background: The purpose of digital remote monitoring (DRM) is improving cancer care management. However, its effectiveness largely depends on the role of nurse navigators (NNs) within these systems to process data and lead action. Objective: This study aims to fill gaps in our understanding of the role of NNs within a specific system, drawing on the Canc{\'e}rologie parcours r{\'e}gion Ile-de-France (CAPRI) DRM program applied to oncology patients. Methods: The CAPRI DRM, targeting patients taking oral anticancer agents, combines digital interfaces with NN interventions. A phase 3 randomized controlled trial involving 559 patients assessed its safety and efficacy, with the primary end point being the relative dose intensity. This report focuses on patients in the CAPRI arm, evaluating the impact of NN interventions on outcomes such as toxicity, hospitalization, and emergency visits. Data on patient characteristics, NN interventions, and patient satisfaction surveys were analyzed using structural equation modeling. Results: The study included 187 patients. Patient characteristics were significantly correlated with outcomes. Across all the models we used, the quality of NN interventions was consistently associated with higher patient satisfaction, with correlation coefficients ranging from 0.332 (95\% CI 0.154-0.510; P<.001) to 0.366 (95\% CI 0.182-0.550; P<.001). The number of grade ?3 toxicity events correlated positively with NN referrals to oncologists. Hospitalization length was positively related to NN referral (coefficient 0.102, 95\% CI 0.051-0.153; P<.001) and inversely to NN advice (coefficient --0.045, 95\% CI --0.096 to 0.006; P=.08). Emergency visits showed a negative correlation with NN actions (coefficient --0.478, 95\% CI --0.923 to 0.033; P=.04) and a positive correlation with NN calls and referrals (coefficient 0.516, 95\% CI 0.069-0.963; P=.02). Conclusions: This study shows the central role of NNs in making DRM effective. Despite the study's limitations, these results support the design of DRM as a hybrid model of automated digital tools and human support. Future research should explore the applicability of such a DRM model in various clinical settings to clarify the optimal association between automated systems and NN expertise. Trial Registration: ClinicalTrials.gov NCT02828462; https://www.clinicaltrials.gov/study/NCT02828462 ",
doi="10.2196/66275",
url="https://www.jmir.org/2025/1/e66275"
}


@Article{info:doi/10.2196/63099,
author="Tremblay, Dominique
and Joly-Mischlich, Thomas
and Dufour, Annick
and Battista, Marie-Claude
and Berbiche, Djamal
and C{\^o}t{\'e}, Jos{\'e}
and D{\'e}celles, Marco
and Forget, Catherine
and Gu{\'e}rin, Brigitte
and Larivi{\`e}re, Manon
and Lemay, Fr{\'e}d{\'e}ric
and Lemonde, Manon
and Maillet, {\'E}ric
and Moreau, Nathalie
and Pavic, Michel
and Soldera, Sara
and Wilhelmy, Catherine",
title="Telehomecare Monitoring for Patients Receiving Anticancer Oral Therapy: Protocol for a Mixed Methods Evaluability Study",
journal="JMIR Res Protoc",
year="2025",
month="Jan",
day="20",
volume="14",
pages="e63099",
keywords="telehealth",
keywords="virtual care",
keywords="telehomecare monitoring",
keywords="anticancer oral therapy",
keywords="oncology",
keywords="electronic patient-reported outcomes",
keywords="electronic patient-reported experience",
keywords="evaluability study",
keywords="mixed methods",
keywords="implementation.",
abstract="Background: Telehomecare monitoring (TM) in patients with cancer is a complex intervention. Research shows variations in the benefits and challenges TM brings to equitable access to care, the therapeutic relationship, self-management, and practice transformation. Further investigation into these variations factors will improve implementation processes and produce effective outcomes. Objective: This study aims to concurrently analyze implementation and evaluate the effectiveness of TM for patients receiving anticancer oral therapy. The objectives are to (1) contextualize how and why TM is implemented according to (a) site characteristics, (b) team characteristics, and (c) characteristics of patients receiving anticancer oral therapy; (2) assess TM effectiveness for recording electronic patient-reported outcome measures (ePROMs) and patient-reported experience measures (ePREMs) according to the site, implementation process, and patient characteristics; (3) describe the acceptability and feasibility of TM from the perspectives of the people directly or indirectly involved and provide evidence-based actionable guidance in anticipation of provincewide implementation. Methods: This type II hybrid effectiveness-implementation study uses a concurrent mixed methods design. Evaluability assessment is integrated into an emerging practice in 3 participating sites to enable the evaluation of implementation strategies on TM clinical outcomes. Quantitative data for ePROMs and ePREMs will be collected using validated oncology questionnaire. Descriptive statistics and repeated measures using multiple linear mixed models and generalized estimating equations analyses will be undertaken alongside interpretive descriptive coding of qualitative data. Qualitative data will be gathered from key informants guided by the RE-AIM (reach, efficacy, adoption, implementation, maintenance) framework and its extension, PRISM (practical robust implementation and sustainability model). The concurrent approach allows results at multiple stages of this study to be integrated iteratively. The methodological choice aims to provide real-world data that are rigorous, rapidly usable in practice, and transferable to other settings. Results: Questionnaires were pretested and the technological platform was codeveloped with members of the cancer care team and patients. Preparatory work was carried out to configure the TM platform and activate coordinating mechanisms between members of the cancer care team, patients, information technology experts, and the research team. A steering committee with 3 working groups was established to oversee the technological, clinical, and evaluation aspects of this study. Recruitment of patients for ePROMs started in February 2024, and data collection is expected to continue until March 2025. Interviews with members of the cancer care team began in November 2024. Full analysis should be completed by September 2025. Conclusions: This study will clarify how, why, for whom, and under what conditions TM can complement current care models. Our evaluability assessment will help to address implementation complexities and better understand intervention-to-practice operationalization so that implementation might be adapted to contextual factors without potentially harmful or inequitable impacts on patients. International Registered Report Identifier (IRRID): DERR1-10.2196/63099 ",
doi="10.2196/63099",
url="https://www.researchprotocols.org/2025/1/e63099"
}


@Article{info:doi/10.2196/57276,
author="Garcia-Saiso, Sebastian
and Marti, Myrna
and Pesce, Karina
and Luciani, Silvana
and Mujica, Oscar
and Hennis, Anselm
and D'Agostino, Marcelo",
title="Artificial Intelligence as a Potential Catalyst to a More Equitable Cancer Care",
journal="JMIR Cancer",
year="2024",
month="Aug",
day="12",
volume="10",
pages="e57276",
keywords="digital health",
keywords="public health",
keywords="cancer",
keywords="artificial intelligence",
keywords="AI",
keywords="catalyst",
keywords="cancer care",
keywords="cost",
keywords="costs",
keywords="demographic",
keywords="epidemiological",
keywords="change",
keywords="changes",
keywords="healthcare",
keywords="equality",
keywords="health system",
keywords="mHealth",
keywords="mobile health",
doi="10.2196/57276",
url="https://cancer.jmir.org/2024/1/e57276",
url="http://www.ncbi.nlm.nih.gov/pubmed/39133537"
}


@Article{info:doi/10.2196/55438,
author="Freeman, Q. Jincong
and Zhao, Fangyuan
and Howard, M. Frederick
and Nanda, Rita
and Olopade, I. Olufunmilayo
and Huo, Dezheng",
title="Assessing the Relationship Between Neighborhood Socioeconomic Disadvantage and Telemedicine Use Among Patients With Breast Cancer and Examining Differential Provisions of Oncology Services Between Telehealth and In-Person Visits: Quantitative Study",
journal="JMIR Cancer",
year="2024",
month="Jul",
day="18",
volume="10",
pages="e55438",
keywords="telemedicine",
keywords="telehealth equity",
keywords="Area Deprivation Index",
keywords="neighborhood socioeconomic disadvantage",
keywords="disparities",
keywords="oncology services",
keywords="treatment consultation",
keywords="genetic counseling",
keywords="in-person visits",
keywords="breast cancer",
keywords="mobile phone",
abstract="Background: Since the COVID-19 pandemic began, we have seen rapid growth in telemedicine use. However, telehealth care and services are not equally distributed, and not all patients with breast cancer have equal access across US regions. There are notable gaps in existing literature regarding the influence of neighborhood-level socioeconomic status on telemedicine use in patients with breast cancer and oncology services offered through telehealth versus in-person visits. Objective: We assessed the relationship between neighborhood socioeconomic disadvantage and telemedicine use among patients with breast cancer and examined differential provisions of oncology services between telehealth and in-person visits. Methods: Neighborhood socioeconomic disadvantage was measured using the Area Deprivation Index (ADI), with higher scores indicating greater disadvantages. Telemedicine and in-person visits were defined as having had a telehealth and in-person visit with a provider, respectively, in the past 12 months. Multivariable logistic regression was performed to examine the association between ADI and telemedicine use. The McNemar test was used to assess match-paired data on types of oncology services comparing telehealth and in-person visits. Results: The mean age of the patients with breast cancer (n=1163) was 61.8 (SD 12.0) years; 4.58\% (52/1161) identified as Asian, 19.72\% (229/1161) as Black, 3.01\% (35/1161) as Hispanic, and 72.78\% (845/1161) as White. Overall, 35.96\% (416/1157) had a telemedicine visit in the past 12 months. Of these patients, 65\% (266/409) had a videoconference visit only, 22.7\% (93/409) had a telephone visit only, and 12.2\% (50/409) had visits by both videoconference and telephone. Higher ADI scores were associated with a lower likelihood of telemedicine use (adjusted odds ratio [AOR] 0.89, 95\% CI 0.82-0.97). Black (AOR 2.38, 95\% CI 1.41-4.00) and Hispanic (AOR 2.65, 95\% CI 1.07-6.58) patients had greater odds of telemedicine use than White patients. Compared to patients with high school or less education, those with an associate's degree (AOR 2.67, 95\% CI 1.33-5.35), a bachelor's degree (AOR 2.75, 95\% CI 1.38-5.48), or a graduate or professional degree (AOR 2.57, 95\% CI 1.31-5.04) had higher odds of telemedicine use in the past 12 months. There were no significant differences in providing treatment consultation (45/405, 11.1\% vs 55/405, 13.6\%; P=.32) or cancer genetic counseling (11/405, 2.7\% vs 19/405, 4.7\%; P=.14) between telehealth and in-person visits. Of the telemedicine users, 95.8\% (390/407) reported being somewhat to extremely satisfied, and 61.8\% (254/411) were likely or very likely to continue using telemedicine. Conclusions: In this study of a multiethnic cohort of patients with breast cancer, our findings suggest that neighborhood-level socioeconomic disparities exist in telemedicine use and that telehealth visits could be used to provide treatment consultation and cancer genetic counseling. Oncology programs should address these disparities and needs to improve care delivery and achieve telehealth equity for their patient populations. ",
doi="10.2196/55438",
url="https://cancer.jmir.org/2024/1/e55438"
}


@Article{info:doi/10.2196/46077,
author="O'Neill, Linda
and Brennan, Louise
and Sheill, Grainne
and Connolly, Deirdre
and Guinan, Emer
and Hussey, Juliette",
title="Moving Forward With Telehealth in Cancer Rehabilitation: Patient Perspectives From a Mixed Methods Study",
journal="JMIR Cancer",
year="2023",
month="Nov",
day="9",
volume="9",
pages="e46077",
keywords="telehealth",
keywords="telemedicine",
keywords="cancer rehabilitation",
keywords="oncology",
keywords="qualitative",
keywords="mixed methods",
keywords="mobile phone",
abstract="Background: The COVID-19 pandemic accelerated the use of telehealth in cancer care and highlighted the potential of telehealth as a means of delivering the much-needed rehabilitation services for patients living with the side effects of cancer and its treatments. Objective: This mixed methods study aims to explore patients' experiences of telehealth and their preferences regarding the use of telehealth for cancer rehabilitation to inform service development. Methods: The study was completed in 2 phases from October 2020 to November 2021. In phase 1, an anonymous survey (web- and paper-based) exploring the need, benefits, barriers, facilitators, and preferences for telehealth cancer rehabilitation was distributed to survivors of cancer in Ireland. In phase 2, survivors of cancer were invited to participate in semistructured interviews exploring their experiences of telehealth and its role in cancer rehabilitation. Interviews were conducted via telephone or video call following an interview guide informed by the results of the survey and transcribed verbatim, and reflexive thematic analysis was performed using a qualitative descriptive approach. Results: A total of 48 valid responses were received. The respondents were at a median of 26 (range 3-256) months after diagnosis, and 23 (48\%) of the 48 participants had completed treatment. Of the 48 respondents, 31 (65\%) reported using telehealth since the start of the pandemic, 15 (31\%) reported having experience with web-based cancer rehabilitation, and 43 (90\%) reported a willingness for web-based cancer rehabilitation. A total of 26 (54\%) of the 48 respondents reported that their views on telehealth had changed positively since the start of the pandemic. Semistructured interviews were held with 18 survivors of cancer. The mean age of the participants was 58.9 (SD 8.24) years, 56\% (10/18) of the participants were female, and 44\% (8/18) of the participants were male. Reflexive thematic analysis identified 5 key themes: telehealth improves accessibility to cancer rehabilitation for some but is a barrier for others, lived experiences of the benefits of telehealth in survivorship, the value of in-person health care, telehealth in cancer care and COVID-19 (from novelty to normality), and the future of telehealth in cancer rehabilitation. Conclusions: Telehealth is broadly welcomed as a mode of cancer rehabilitation for patients living with and beyond cancer in Ireland. However, issues regarding accessibility and the importance of in-person care must be acknowledged. Factors of convenience, time savings, and cost savings indicate that telehealth interventions are a desirable patient-centered method of delivering care when performed in suitable clinical contexts and with appropriate populations. ",
doi="10.2196/46077",
url="https://cancer.jmir.org/2023/1/e46077",
url="http://www.ncbi.nlm.nih.gov/pubmed/37943595"
}


@Article{info:doi/10.2196/41101,
author="Raso, Kristy-Lee
and Suen, Michael
and Turner, Jane
and Khatri, Sonia
and Lin, Yanlan
and Wildbore, Carolyn
and Becerril-Martinez, Guillermo
and Le Page, Philip
and Tan, Yee Sim
and Egger, Sam
and Vardy, Janette",
title="Prehabilitation Before Gastrointestinal Cancer Surgery: Protocol for an Implementation Study",
journal="JMIR Res Protoc",
year="2023",
month="Mar",
day="27",
volume="12",
pages="e41101",
keywords="prehabilitation",
keywords="gastrointestinal",
keywords="cancer",
keywords="surgery",
keywords="exercise",
keywords="nutrition",
keywords="telehealth",
keywords="colorectal",
keywords="psychological",
abstract="Background: Surgery remains the standard curative treatment for early-stage colorectal and upper gastrointestinal cancer. Reduced preoperative functional capacity, nutritional status, and psychological well-being are associated with poor postoperative outcomes. Prehabilitation aims to improve preoperative functional reserves through physical, nutritional, and psychological interventions. Yet, how it transitions from a trial setting to being integrated into a real-world health setting is unknown. Objective: The primary aim is to evaluate the implementation of a multimodal (supervised exercise, nutrition, and nursing support) prehabilitation program into standard care for patients with gastrointestinal cancer (colorectal and upper gastrointestinal cancer) scheduled for curative intent surgery. The secondary aim is to determine the impact of a multimodal prehabilitation program on functional capacity, nutritional and psychological status, and surgical outcomes. Methods: This is an implementation study that will investigate a multimodal prehabilitation intervention, in a nonblinded, nonrandomized, single-group, pre-post design. Patients diagnosed with colorectal and upper gastrointestinal cancer scheduled for potentially curative intent surgery at Concord Repatriation General Hospital, with ?14 intervention days prior to surgery and are medically cleared to exercise will be eligible. The study will be evaluated using the Reach, Effectiveness, Adoption, Implementation, and Maintenance Evaluation Framework. Results: The protocol was approved in December 2019 by the Concord Repatriation General Hospital Human Research Ethics Committee (reference number 2019/PID13679). Recruitment commenced in January 2020. In response to the COVID-19 pandemic, recruitment was paused in March 2020 and reopened in August 2020 with remote or telehealth intervention adaptations. Recruitment ended on December 31, 2021. Over the 16-month recruitment period, a total of 77 participants were recruited. Conclusions: Prehabilitation represents an opportunity to maximize functional capacity and improve surgical outcomes. The study will provide guidance and contribute to the evidence on the integration of prehabilitation into standard care using adaptive models of health care delivery including telehealth. Trial Registration: Australian and New Zealand Clinical Trials Registry ACTR 12620000409976; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378974\&isReview=true International Registered Report Identifier (IRRID): RR1-10.2196/41101 ",
doi="10.2196/41101",
url="https://www.researchprotocols.org/2023/1/e41101",
url="http://www.ncbi.nlm.nih.gov/pubmed/36972114"
}


@Article{info:doi/10.2196/42334,
author="Yu, Liyang
and Liu, You-Chi
and Cornelius, L. Sarah
and Scodari, T. Bruno
and Brooks, A. Gabriel
and O'Malley, James Alistair
and Onega, Tracy
and Moen, L. Erika",
title="Telehealth Use Following COVID-19 Within Patient-Sharing Physician Networks at a Rural Comprehensive Cancer Center: Cross-sectional Analysis",
journal="JMIR Cancer",
year="2023",
month="Jan",
day="17",
volume="9",
pages="e42334",
keywords="telehealth",
keywords="rural cancer care",
keywords="patient-sharing networks",
keywords="network analysis",
keywords="COVID-19",
keywords="cancer care",
keywords="telemedicine",
keywords="oncology",
keywords="oncologist",
keywords="electronic health record data",
keywords="health system",
keywords="patient network",
abstract="Background: In response to the COVID-19 pandemic, cancer centers rapidly adopted telehealth to deliver care remotely. Telehealth will likely remain a model of care for years to come and may not only affect the way oncologists deliver care to their own patients but also the physicians with whom they share patients. Objective: This study aimed to examine oncologist characteristics associated with telehealth use and compare patient-sharing networks before and after the COVID-19 pandemic in a rural catchment area with a particular focus on the ties between physicians at the comprehensive cancer center and regional facilities. Methods: In this retrospective observational study, we obtained deidentified electronic health record data for individuals diagnosed with breast, colorectal, or lung cancer at Dartmouth Health in New Hampshire from 2018-2020. Hierarchical logistic regression was used to identify physician factors associated with telehealth encounters post COVID-19. Patient-sharing networks for each cancer type before and post COVID-19 were characterized with global network measures. Exponential-family random graph models were performed to estimate homophily terms for the likelihood of ties existing between physicians colocated at the hub comprehensive cancer center. Results: Of the 12,559 encounters between patients and oncologists post COVID-19, 1228 (9.8\%) were via telehealth. Patient encounters with breast oncologists who practiced at the hub hospital were over twice as likely to occur via telehealth compared to encounters with oncologists who practiced in regional facilities (odds ratio 2.2, 95\% CI 1.17-4.15; P=.01). Patient encounters with oncologists who practiced in multiple locations were less likely to occur via telehealth, and this association was statistically significant for lung cancer care (odds ratio 0.26, 95\% CI 0.09-0.76; P=.01). We observed an increase in ties between oncologists at the hub hospital and oncologists at regional facilities in the lung cancer network post COVID-19 compared to before COVID-19 (93/318, 29.3\%, vs 79/370, 21.6\%, respectively), which was also reflected in the lower homophily coefficients post COVID-19 compared to before COVID-19 for physicians being colocated at the hub hospital (estimate: 1.92, 95\% CI 1.46-2.51, vs 2.45, 95\% CI 1.98-3.02). There were no significant differences observed in breast cancer or colorectal cancer networks. Conclusions: Telehealth use and associated changes to patient-sharing patterns associated with telehealth varied by cancer type, suggesting disparate approaches for integrating telehealth across clinical groups within this health system. The limited changes to the patient-sharing patterns between oncologists at the hub hospital and regional facilities suggest that telehealth was less likely to create new referral patterns between these types of facilities and rather replace care that would otherwise have been delivered in person. However, this study was limited to the 2 years immediately following the initial outbreak of COVID-19, and longer-term follow-up may uncover delayed effects that were not observed in this study period. ",
doi="10.2196/42334",
url="https://cancer.jmir.org/2023/1/e42334",
url="http://www.ncbi.nlm.nih.gov/pubmed/36595737"
}


@Article{info:doi/10.2196/33768,
author="Mackwood, Matthew
and Butcher, Rebecca
and Vaclavik, Danielle
and Alford-Teaster, A. Jennifer
and Curtis, M. Kevin
and Lowry, Mary
and Tosteson, D. Tor
and Zhao, Wenyan
and Tosteson, A. Anna N.",
title="Adoption of Telemedicine in a Rural US Cancer Center Amid the COVID-19 Pandemic: Qualitative Study",
journal="JMIR Cancer",
year="2022",
month="Aug",
day="16",
volume="8",
number="3",
pages="e33768",
keywords="telemedicine",
keywords="telehealth",
keywords="remote consultation",
keywords="clinical oncology",
keywords="implementation science",
keywords="qualitative research",
keywords="telemedicine methods",
keywords="telemedicine organization and administration",
keywords="telemedicine trends",
keywords="clinical oncology methods",
keywords="clinical oncology organization and administration",
keywords="oncology",
keywords="digital health",
keywords="virtual care",
keywords="COVID-19",
abstract="Background: The COVID-19 pandemic necessitated a rapid shift to telemedicine to minimize patient and provider exposure risks. While telemedicine has been used in a variety of primary and specialty care settings for many years, it has been slow to be adopted in oncology care. Health care provider and administrator perspectives on factors affecting telemedicine use in oncology settings are not well understood, and the conditions associated with the COVID-19 pandemic offered the opportunity to study the adoption of telemedicine and the resulting provider and staff perspectives on its use. Objective: The aim of this paper is to study the factors that influenced telemedicine uptake and sustained use in outpatient oncology clinics at a US cancer center to inform future telemedicine practices. Methods: We used purposive sampling to recruit a mix of oncology specialty providers, practice managers, as well as nursing and administrative staff representing 5 outpatient oncology clinics affiliated with the Dartmouth Cancer Center, a large regional cancer center in the northeast of United States, to participate in semistructured interviews conducted over 6 weeks in spring 2021. The interview guide was informed by the 5 domains of the Consolidated Framework for Implementation Research, which include inner and outer setting factors, characteristics of the intervention (ie, telemedicine modality), individual-level factors (eg, provider and patient characteristics), and implementation processes. In total, 11 providers, 3 leaders, and 6 staff participated following verbal consent, and thematic saturation was reached across the full sample. We used a mixed deductive and inductive qualitative analysis approach to study the main influences on telemedicine uptake, implementation, and sustainability during the first year of the COVID-19 pandemic across the 5 settings. Results: The predominant influencers of telemedicine adoption in this study were individual provider experiences and assumptions about patient preference and accessibility. Providers' early telemedicine experiences, especially if negative, influenced preferences for telephone over video and affected sustained use. Telemedicine was most favorably viewed for lower-acuity cancer care, visits less dependent on physical exam, and for patient and caregiver education. A lack of clinical champions, leadership guidance, and vision hindered the implementation of standardized practices and were cited as essential for telemedicine sustainability. Respondents expressed anxiety about sustaining telemedicine use if reimbursements for telephonic visits diminished or ceased. Opportunities to enhance future efforts include a need to provide additional guidance supporting telemedicine use cases and evidence of effectiveness in oncology care and to address provider concerns with communication quality. Conclusions: In a setting of decentralized care processes, early challenges in telemedicine implementation had an outsized impact on the nature and amount of sustained use. Proactively designed telemedicine care processes with attention to patient needs will be essential to support a sustained role for telemedicine in cancer care. ",
doi="10.2196/33768",
url="https://cancer.jmir.org/2022/3/e33768",
url="http://www.ncbi.nlm.nih.gov/pubmed/35895904"
}


@Article{info:doi/10.2196/34895,
author="Alpert, M. Jordan
and Taylor, Greenberry
and Hampton, N. Chelsea
and Paige, Samantha
and Markham, Jennifer Merry
and Bylund, L. Carma",
title="Clinicians' Perceptions of the Benefits and Challenges of Teleoncology as Experienced Through the COVID-19 Pandemic: Qualitative Study",
journal="JMIR Cancer",
year="2022",
month="Feb",
day="24",
volume="8",
number="1",
pages="e34895",
keywords="teleoncology",
keywords="telemedicine",
keywords="qualitative",
keywords="COVID-19",
keywords="telehealth",
keywords="cancer care",
keywords="cancer",
keywords="oncology",
keywords="digital health",
keywords="pandemic",
abstract="Background: COVID-19 thrust both patients and clinicians to use telemedicine in place of traditional in-person visits. Prepandemic, limited research had examined clinician-patient communication in telemedicine visits. The shift to telemedicine in oncology, or teleoncology, has placed attention on how the technology can be utilized to provide care for patients with cancer. Objective: Our objective was to describe oncology clinicians' experiences with teleoncology and to uncover its benefits and challenges during the first 10 months of the COVID-19 pandemic. Methods: In-depth, semistructured qualitative interviews were conducted with oncology clinicians. Using an inductive, thematic approach, the most prevalent themes were identified. Results: In total, 21 interviews with oncology clinicians revealed the following themes: benefits of teleoncology, such as (1) reducing patients' travel time and expenses, (2) limiting COVID-19 exposure, and (3) enabling clinicians to ``see'' a patients' lifestyle and environment, and challenges, such as (1) technological connection difficulties, (2) inability to physically examine patients, and (3) patients' frustration related to clinicians being late to teleoncology appointments. Conclusions: Teleoncology has many benefits and is well suited for specific types of appointments. Challenges could be addressed through improved communication when scheduling appointments to make patients aware about what to expect. Ensuring patients have the proper technology to participate in teleoncology and an understanding about how it functions are necessary. ",
doi="10.2196/34895",
url="https://cancer.jmir.org/2022/1/e34895",
url="http://www.ncbi.nlm.nih.gov/pubmed/35142622"
}


@Article{info:doi/10.2196/29635,
author="Turner, Kea
and Bobonis Babilonia, Margarita
and Naso, Cristina
and Nguyen, Oliver
and Gonzalez, D. Brian
and Oswald, B. Laura
and Robinson, Edmondo
and Elston Lafata, Jennifer
and Ferguson, J. Robert
and Alishahi Tabriz, Amir
and Patel, B. Krupal
and Hallanger-Johnson, Julie
and Aldawoodi, Nasrin
and Hong, Young-Rock
and Jim, L. Heather S.
and Spiess, E. Philippe",
title="Health Care Providers' and Professionals' Experiences With Telehealth Oncology Implementation During the COVID-19 Pandemic: A Qualitative Study",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="19",
volume="24",
number="1",
pages="e29635",
keywords="telehealth",
keywords="telemedicine",
keywords="teleoncology",
keywords="digital health",
keywords="remote monitoring",
keywords="cancer",
keywords="oncology",
keywords="coronavirus disease",
keywords="COVID-19",
abstract="Background: Rapid implementation of telehealth for cancer care during COVID-19 required innovative and adaptive solutions among oncology health care providers and professionals (HPPs). Objective: The aim of this qualitative study was to explore oncology HPPs' experiences with telehealth implementation during the COVID-19 pandemic. Methods: This study was conducted at Moffitt Cancer Center (Moffitt), an NCI (National Cancer Institute)-Designated Comprehensive Cancer Center. Prior to COVID-19, Moffitt piloted telehealth visits on a limited basis. After COVID-19, Moffitt rapidly expanded telehealth visits. Telehealth visits included real-time videoconferencing between HPPs and patients and virtual check-ins (ie, brief communication with an HPP by telephone only). We conducted semistructured interviews with 40 oncology HPPs who implemented telehealth during COVID-19. The interviews were recorded, transcribed verbatim, and analyzed for themes using Dedoose software (version 4.12). Results: Approximately half of the 40 participants were physicians (n=22, 55\%), and one-quarter of the participants were advanced practice providers (n=10, 25\%). Other participants included social workers (n=3, 8\%), psychologists (n=2, 5\%), dieticians (n=2, 5\%), and a pharmacist (n=1, 3\%). Five key themes were identified: (1) establishing and maintaining patient-HPP relationships, (2) coordinating care with other HPPs and informal caregivers, (3) adapting in-person assessments for telehealth, (4) developing workflows and allocating resources, and (5) future recommendations. Participants described innovative strategies for implementing telehealth, such as coordinating interdisciplinary visits with multiple HPPs and inviting informal caregivers (eg, spouse) to participate in telehealth visits. Health care workers discussed key challenges, such as workflow integration, lack of physical exam and biometric data, and overcoming the digital divide (eg, telehealth accessibility among patients with communication-related disabilities). Participants recommended policy advocacy to support telehealth (eg, medical licensure policies) and monitoring how telehealth affects patient outcomes and health care delivery. Conclusions: To support telehealth growth, implementation strategies are needed to ensure that HPPs and patients have the tools necessary to effectively engage in telehealth. At the same time, cancer care organizations will need to engage in advocacy to ensure that policies are supportive of oncology telehealth and develop systems to monitor the impact of telehealth on patient outcomes, health care quality, costs, and equity. ",
doi="10.2196/29635",
url="https://www.jmir.org/2022/1/e29635",
url="http://www.ncbi.nlm.nih.gov/pubmed/34907900"
}


@Article{info:doi/10.2196/28709,
author="Wilson-Howard, Danyell
and Vilaro, J. Melissa
and Neil, M. Jordan
and Cooks, J. Eric
and Griffin, N. Lauren
and Ashley, T. Taylor
and Tavassoli, Fatemeh
and Zalake, S. Mohan
and Lok, C. Benjamin
and Odedina, T. Folakemi
and Modave, Francois
and Carek, J. Peter
and George, J. Thomas
and Krieger, L. Janice",
title="Development of a Credible Virtual Clinician Promoting Colorectal Cancer Screening via Telehealth Apps for and by Black Men: Qualitative Study",
journal="JMIR Form Res",
year="2021",
month="Dec",
day="24",
volume="5",
number="12",
pages="e28709",
keywords="telehealth",
keywords="digital health",
keywords="eHealth",
keywords="colorectal cancer",
keywords="Black men",
keywords="virtual human",
keywords="technology",
keywords="cancer screening",
keywords="app",
keywords="cancer",
keywords="prevention",
keywords="development",
abstract="Background: Traditionally, promotion of colorectal cancer (CRC) screening among Black men was delivered by community health workers, patient navigators, and decision aids (printed text or video media) at clinics and in the community setting. A novel approach to increase CRC screening of Black men includes developing and utilizing a patient-centered, tailored message delivered via virtual human technology in the privacy of one's home. Objective: The objective of this study was to incorporate the perceptions of Black men in the development of a virtual clinician (VC) designed to deliver precision messages promoting the fecal immunochemical test (FIT) kit for CRC screening among Black men in a future clinical trial. Methods: Focus groups of Black men were recruited to understand their perceptions of a Black male VC. Specifically, these men identified source characteristics that would enhance the credibility of the VC. The modality, agency, interactivity, and navigability (MAIN) model, which examines how interface features affect the user's psychology through four affordances (modality, agency, interactivity, and navigability), was used to assess the presumed credibility of the VC and likability of the app from the focus group transcripts. Each affordance triggers heuristic cues that stimulate a positive or a negative perception of trustworthiness, believability, and understandability, thereby increasing source credibility. Results: In total, 25 Black men were recruited from the community and contributed to the development of 3 iterations of a Black male VC over an 18-month time span. Feedback from the men enhanced the visual appearance of the VC, including its movement, clothing, facial expressions, and environmental surroundings. Heuristics, including social presence, novelty, and authority, were all recognized by the final version of the VC, and creditably was established.  The VC was named Agent Leveraging Empathy for eXams (ALEX) and referred to as ``brother-doctor,'' and participants stated ``wanting to interact with ALEX over their regular doctor.'' Conclusions: Involving Black men in the development of a digital health care intervention is critical. This population is burdened by cancer health disparities, and incorporating their perceptions in telehealth interventions will create awareness of the need to develop targeted messages for Black men. ",
doi="10.2196/28709",
url="https://formative.jmir.org/2021/12/e28709",
url="http://www.ncbi.nlm.nih.gov/pubmed/34780346"
}


@Article{info:doi/10.2196/26220,
author="Blasi, Livio
and Bordonaro, Roberto
and Serretta, Vincenzo
and Piazza, Dario
and Firenze, Alberto
and Gebbia, Vittorio",
title="Virtual Clinical and Precision Medicine Tumor Boards---Cloud-Based Platform--Mediated Implementation of Multidisciplinary Reviews Among Oncology Centers in the COVID-19 Era: Protocol for an Observational Study",
journal="JMIR Res Protoc",
year="2021",
month="Sep",
day="10",
volume="10",
number="9",
pages="e26220",
keywords="virtual tumor board",
keywords="multidisciplinary collaboration",
keywords="oncology",
keywords="multidisciplinary communication",
keywords="health services",
keywords="multidisciplinary oncology consultations",
keywords="virtual health",
keywords="digital health",
keywords="precision medicine",
keywords="tumor",
keywords="cancer",
keywords="cloud-based",
keywords="platform",
keywords="implementation",
keywords="COVID-19",
abstract="Background: Multidisciplinary tumor boards play a pivotal role in the patient-centered clinical management and in the decision-making process to provide best evidence-based, diagnostic, and therapeutic care to patients with cancer. Among the barriers to achieve an efficient multidisciplinary tumor board, lack of time and geographical distance play a major role. Therefore, the elaboration of an efficient virtual multidisciplinary tumor board (VMTB) is a key point to successfully obtain an oncology team and implement a network among health professionals and institutions. This need is stronger than ever during the COVID-19 pandemic. Objective: This paper presents a research protocol for an observational study focused on exploring the structuring process and the implementation of a multi-institutional VMTB in Sicily, Italy. Other endpoints include analysis of cooperation between participants, adherence to guidelines, patients' outcomes, and patient satisfaction. Methods: This protocol encompasses a pragmatic, observational, multicenter, noninterventional, prospective trial. The study's programmed duration is 5 years, with a half-yearly analysis of the primary and secondary objectives' measurements. Oncology care health professionals from various oncology subspecialties at oncology departments in multiple hospitals (academic and general hospitals as well as tertiary centers and community hospitals) are involved in a nonhierarchic manner. VMTB employs an innovative, virtual, cloud-based platform to share anonymized medical data that are discussed via a videoconferencing system both satisfying security criteria and compliance with the Health Insurance Portability and Accountability Act. Results: The protocol is part of a larger research project on communication and multidisciplinary collaboration in oncology units and departments spread in the Sicily region. The results of this study will particularly focus on the organization of VMTBs, involving oncology units present in different hospitals spread in the area, and creating a network to allow best patient care pathways and a hub-and-spoke relationship. The present results will also include data concerning organization skills and pitfalls, barriers, efficiency, number, and types with respect to clinical cases and customer satisfaction. Conclusions: VMTB represents a unique opportunity to optimize patient management through a patient-centered approach. An efficient virtualization and data-banking system is potentially time-saving, a source for outcome data, and a detector of possible holes in the hull of clinical pathways. The observations and results from this VMTB study may hopefully be useful to design nonclinical and organizational interventions that enhance multidisciplinary decision-making in oncology. International Registered Report Identifier (IRRID): DERR1-10.2196/26220 ",
doi="10.2196/26220",
url="https://www.researchprotocols.org/2021/9/e26220",
url="http://www.ncbi.nlm.nih.gov/pubmed/34387553"
}


@Article{info:doi/10.2196/30549,
author="Denis, Fabrice
and Krakowski, Ivan",
title="How Should Oncologists Choose an Electronic Patient-Reported Outcome System for Remote Monitoring of Patients With Cancer?",
journal="J Med Internet Res",
year="2021",
month="Sep",
day="9",
volume="23",
number="9",
pages="e30549",
keywords="ePRO",
keywords="cancer",
keywords="remote monitoring",
keywords="quality",
keywords="effectiveness",
keywords="security",
keywords="digital monitoring",
keywords="digital health",
keywords="cancer patients",
keywords="patients with cancer",
keywords="oncology",
doi="10.2196/30549",
url="https://www.jmir.org/2021/9/e30549",
url="http://www.ncbi.nlm.nih.gov/pubmed/34499046"
}


@Article{info:doi/10.2196/29619,
author="Shah, C. Aashaka
and O'Dwyer, C. Linda
and Badawy, M. Sherif",
title="Telemedicine in Malignant and Nonmalignant Hematology: Systematic Review of Pediatric and Adult Studies",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Jul",
day="8",
volume="9",
number="7",
pages="e29619",
keywords="telemedicine",
keywords="telehealth",
keywords="eHealth",
keywords="Digital Health",
keywords="Digital Medicine",
keywords="mHealth",
keywords="hematology",
keywords="malignant",
keywords="nonmalignant",
keywords="intervention",
abstract="Background: Telemedicine, including video-, web-, and telephone-based interventions, is used in adult and pediatric populations to deliver health care and communicate with patients. In the realm of hematology, telemedicine has recently been used to safely and efficiently monitor treatment side-effects, perform consultations, and broaden the reach of subspecialty care. Objective: We aimed to synthesize and analyze information regarding the feasibility, acceptability, and potential benefits of telemedicine interventions in malignant and nonmalignant hematology, as well as assess the recognized limitations of these interventions. Methods: Studies were identified through a comprehensive Medical Subject Headings (MeSH) search on the PubMed MEDLINE, Controlled Register of Clinical Trials (Cochrane CENTRAL from Wiley), Embase, and CINAHL (EBSCO) databases on February 7, 2018. A second search, utilizing the same search strategy, was performed on October 1, 2020. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the reporting of included evidence. Included studies were original articles researching the feasibility, acceptability, and clinical outcomes of telemedicine or telehealth interventions in pediatric or adult populations with malignant or nonmalignant hematological conditions. Data items in the extraction form included first author name, publication year, country, malignant or nonmalignant hematological condition or disease focus of the study, participant age, participant age subgroup (pediatric or adult), study design and setting, telemedicine intervention type and description, study purpose, and main study outcomes. Results: A total of 32 articles met the preset criteria and were included in this study. Most (25/32) studies were conducted in adults, and the remaining (7/32) were conducted in the pediatric population. Of the 32 studies, 12 studied malignant hematological conditions, 18 studied nonmalignant conditions, and two studied both malignant and nonmalignant conditions. Study types included pilot study (11/32), retrospective study (9/32), randomized controlled trial (6/32), cross-sectional study (2/32), case study (1/32), pre-post study (1/32), noncomparative prospective study (1/32), and prospective cohort study (1/32). The three main types of telemedicine interventions utilized across all studies were video-based (9/32), telephone-based (9/32), and web-based interventions (14/32). Study results showed comparable outcomes between telemedicine and traditional patient encounter groups across both pediatric and adult populations for malignant and nonmalignant hematological conditions. Conclusions: Evidence from this review suggests that telemedicine use in nonmalignant and malignant hematology provides similar or improved health care compared to face-to-face encounters in both pediatric and adult populations. Telemedicine interventions utilized in the included studies were well received in both pediatric and adult settings. However, more research is needed to determine the efficacy of implementing more widespread use of telemedicine for hematological conditions. ",
doi="10.2196/29619",
url="https://mhealth.jmir.org/2021/7/e29619",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255706"
}


@Article{info:doi/10.2196/30090,
author="Bandiera, Carole
and Cardoso, Evelina
and Locatelli, Isabella
and Digklia, Antonia
and Zaman, Khalil
and Diciolla, Antonella
and Cristina, Val{\'e}rie
and Stravodimou, Athina
and Veronica, Lopez Aedo
and Dolcan, Ana
and Sarivalasis, Apostolos
and Liapi, Aikaterini
and Bouchaab, Hasna
and Orcurto, Angela
and Dotta-Celio, Jennifer
and Peters, Solange
and Decosterd, Laurent
and Widmer, Nicolas
and Wagner, Dorothea
and Csajka, Chantal
and Schneider, Paule Marie",
title="Optimizing Oral Targeted Anticancer Therapies Study for Patients With Solid Cancer: Protocol for a Randomized Controlled Medication Adherence Program Along With Systematic Collection and Modeling of Pharmacokinetic and Pharmacodynamic Data",
journal="JMIR Res Protoc",
year="2021",
month="Jun",
day="29",
volume="10",
number="6",
pages="e30090",
keywords="neoplasms",
keywords="medication adherence",
keywords="oral anticancer therapies",
keywords="interprofessional program",
keywords="adherence electronic measure",
keywords="pharmacokinetics",
keywords="pharmacodynamics",
keywords="NONMEM",
keywords="motivational interviewing",
abstract="Background: The strengthening or substitution of intravenous cytotoxic chemotherapy cycles by oral targeted anticancer therapies, such as protein kinase inhibitors (PKIs), has provided impressive clinical benefits and autonomy as well as a better quality of life for patients with cancer. Despite these advances, adverse event management at home and medication adherence remain challenging. In addition, PKI plasma concentrations vary significantly among patients with cancer receiving the same dosage, which could explain part of the observed variability in the therapeutic response. Objective: The aim of this optimizing oral targeted anticancer therapies (OpTAT) study is to optimize and individualize targeted anticancer treatments to improve patient care and self-monitoring through an interprofessional medication adherence program (IMAP) combined with measurement PKI plasma concentrations. Methods: The OpTAT study has two parts: (1) a 1:1 randomized medication adherence program, in which the intervention consists of regular motivational interviewing sessions between the patient and the pharmacist, along with the delivery of PKIs in electronic monitors, and (2) a systematic collection of blood samples and clinical and biological data for combined pharmacokinetic and pharmacodynamic analysis. On the basis of the electronic monitor data, medication adherence will be compared between groups following the three operational definitions: implementation of treatment during the persistent period, persistence with treatment and longitudinal adherence. The implementation will be described using generalized estimating equation models. The persistence of PKI use will be represented using a Kaplan-Meier survival curve. Longitudinal adherence is defined as the product of persistence and implementation. PKI pharmacokinetics will be studied using a population approach. The relationship between drug exposure and efficacy outcomes will be explored using Cox regression analysis of progression-free survival. The relationship between drug exposure and toxicity will be analyzed using a pharmacokinetic-pharmacodynamic model and by logistic regression analysis. Receiver operating characteristic analyses will be applied to evaluate the best exposure threshold associated with clinical benefits. Results: The first patient was included in May 2015. As of June 2021, 262 patients had participated in at least one part of the study: 250 patients gave at least one blood sample, and 130 participated in the adherence study. Data collection is in process, and the final data analysis is planned to be performed in 2022. Conclusions: The OpTAT study will inform us about the effectiveness of the IMAP program in patients with solid cancers treated with PKIs. It will also shed light on PKI pharmacokinetic and pharmacodynamic properties, with the aim of learning how to adapt the PKI dosage at the individual patient level to increase PKI clinical suitability. The IMAP program will enable interprofessional teams to learn about patients' needs and to consider their concerns about their PKI self-management, considering the patient as an active partner. Trial Registration: ClinicalTrials.gov NCT04484064; https://clinicaltrials.gov/ct2/show/NCT04484064. International Registered Report Identifier (IRRID): DERR1-10.2196/30090 ",
doi="10.2196/30090",
url="https://www.researchprotocols.org/2021/6/e30090",
url="http://www.ncbi.nlm.nih.gov/pubmed/34185020"
}


@Article{info:doi/10.2196/27940,
author="Koppel, D. Paula
and De Gagne, C. Jennie",
title="Exploring Nurse and Patient Experiences of Developing Rapport During Oncology Ambulatory Care Videoconferencing Visits: Protocol for a Qualitative Study",
journal="JMIR Res Protoc",
year="2021",
month="Jun",
day="14",
volume="10",
number="6",
pages="e27940",
keywords="nursing",
keywords="oncology ambulatory care",
keywords="provider-patient relationship",
keywords="rapport",
keywords="telehealth",
keywords="videoconferencing visits",
abstract="Background: Telehealth videoconferencing has largely been embraced by health care providers and patients during the COVID-19 pandemic; however, little is known about specific techniques for building rapport and provider-patient relationships in this care environment. Although research suggests that videoconferencing is feasible and can be effective for some types of care, concerns about the impact of technology on provider-patient relationships exist across health disciplines. Suggestions for adapting some in-person rapport techniques, such as the use of small talk, eye contact, and body language to facilitate trust, personal connection, and communication during videoconferencing encounters, have been discussed in the popular press and clinical commentaries. Notably, evidence regarding the effects of these strategies on rapport and clinical care outcomes is lacking. Understanding how to establish rapport in videoconferencing visits is especially important in oncology nursing, where rapport with patients enables nurses to become a source of emotional support, helping patients adapt and navigate the cancer journey. Objective: This study aims to investigate the nature of nurse-patient rapport in ambulatory cancer care videoconferencing visits. The objectives include exploring how patients with cancer and nurses describe experiences of rapport and strategies for cultivating rapport in videoconferencing visits and similarities and differences identified by patients with cancer and nurses between experiences of rapport in videoconferencing and in-person visits. Methods: Semistructured narrative interviews of patients with cancer and nurses will be conducted to understand the experience of rapport building in videoconferencing visits. Nurses and patients will be interviewed separately to facilitate an understanding of the perspectives of both types of participants. Interviews will be conducted on a secure videoconferencing platform. This qualitative descriptive study will describe participant experiences in a manner that, although not without interpretation, is as close to the data as possible. The research team will meet regularly to discuss, define, and document codes, categories, and themes, and the team will maintain a detailed audit trail of analytical decisions. In addition, member checking will enhance the rigor of the study. Nurse and patient interviews will be analyzed separately using identical procedures and may be explored side by side in the final analysis to provide a comparative analysis. Data management and analysis will be performed using NVivo 12. Results: Data collection will begin during summer 2021, with results from the data analysis anticipated by winter 2021. A research team trained in qualitative methodology will use conventional content analysis to analyze the data using first- and second-level codes derived directly from the transcribed text data. Conclusions: This study aims to determine what behaviors, communication techniques, and relational practices need to be adapted in videoconferencing telehealth visits, setting the foundation for future development of interventions and evidence-based practice guidelines for relationship building during videoconferencing telehealth visits. International Registered Report Identifier (IRRID): PRR1-10.2196/27940 ",
doi="10.2196/27940",
url="https://www.researchprotocols.org/2021/6/e27940",
url="http://www.ncbi.nlm.nih.gov/pubmed/34125073"
}


@Article{info:doi/10.2196/24908,
author="Huygens, J. Martine W.
and Voogdt-Pruis, R. Helene
and Wouters, Myrah
and Meurs, M. Maaike
and van Lettow, Britt
and Kleijweg, Conchita
and Friele, D. Roland",
title="The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands",
journal="J Med Internet Res",
year="2021",
month="May",
day="3",
volume="23",
number="5",
pages="e24908",
keywords="eHealth",
keywords="telemonitoring",
keywords="self-management",
keywords="telemedicine",
keywords="telehealth",
abstract="Background: Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. Objective: This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. Methods: Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. Results: Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2\% (18/161) in 2014 to 19.6\% (36/184) in 2019 ($\chi$24=12.3; P=.02). In 2019, telemonitoring was used by 5.8\% (28/485) of people with chronic disease. This was 18.2\% (41/225) in GP organizations and 40.4\% (44/109), 38.0\% (78/205), and 8.9\% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10\% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were ``comfort'' (421/1043, 40.4\%) and ``living at home for longer/more comfortably'' (334/1047, 31.9\%). Health care professionals added ``improvement of self-management'' (63/176, 35.8\% to 57/71, 80.3\%), ``better understanding of the patient's condition'' (47/176, 26.7\% to 42/71, 59.2\%), ``reduction of workload'' (53/134, 39.6\% of nurses in elderly care), ``better tailoring of care plan to the patient's situation'' (95/225, 42.2\% of GPs), and ``saves time for patients/caregivers'' (61/176, 34.7\% of medical specialists). Disadvantages mentioned by professionals were that ``it takes time to monitor data'' (13/130, 10\% to 108/225, 48.0\%), ``it takes time to follow up alerts'' (15/130, 11.5\% to 117/225, 52.0\%), and ``it is difficult to estimate which patients can work with telemonitoring'' (22/113, 19.5\% to 94/225, 41.8\%). Conclusions: The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring. ",
doi="10.2196/24908",
url="https://www.jmir.org/2021/5/e24908",
url="http://www.ncbi.nlm.nih.gov/pubmed/33938808"
}


@Article{info:doi/10.2196/26799,
author="Fu, Zhiying
and Jiang, Min
and Wang, Kun
and Li, Jian",
title="Minimizing the Impact of the COVID-19 Epidemic on Oncology Clinical Trials: Retrospective Study of Beijing Cancer Hospital",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="2",
volume="23",
number="3",
pages="e26799",
keywords="COVID-19",
keywords="clinical trials",
keywords="management strategy",
keywords="information technology",
abstract="Background: In view of repeated COVID-19 outbreaks in most countries, clinical trials will continue to be conducted under outbreak prevention and control measures for the next few years. It is very significant to explore an optimal clinical trial management model during the outbreak period to provide reference and insight for other clinical trial centers worldwide. Objective: The aim of this study was to explore the management strategies used to minimize the impact of the COVID-19 epidemic on oncology clinical trials. Methods: We implemented a remote management model to maintain clinical trials conducted at Beijing Cancer Hospital, which realized remote project approval, remote initiation, remote visits, remote administration and remote monitoring to get through two COVID-19 outbreaks in the capital city from February to April and June to July 2020. The effectiveness of measures was evaluated as differences in rates of protocol compliance, participants lost to follow-up, participant withdrawal, disease progression, participant mortality, and detection of monitoring problems. Results: During the late of the first outbreak, modifications were made in trial processing, participant management and quality control, which allowed the hospital to ensure the smooth conduct of 572 trials, with a protocol compliance rate of 85.24\% for 3718 participants across both outbreaks. No COVID-19 infections were recorded among participants or trial staff, and no major procedural errors occurred between February and July 2020. These measures led to significantly higher rates of protocol compliance and significantly lower rates of loss to follow-up or withdrawal after the second outbreak than after the first, without affecting rates of disease progression or mortality. The hospital provided trial sponsors with a remote monitoring system in a timely manner, and 3820 trial issues were identified. Conclusions: When public health emergencies occur, an optimal clinical trial model combining on-site and remote management could guarantee the health care and treatment needs of clinical trial participants, in which remote management plays a key role. ",
doi="10.2196/26799",
url="https://www.jmir.org/2021/3/e26799",
url="http://www.ncbi.nlm.nih.gov/pubmed/33591924"
}


@Article{info:doi/10.2196/15598,
author="O'Cathail, Micheal
and Aznar-Garcia, Luis
and Sivanandan, Ananth
and Diver, Claire
and Patel, Poulam
and Tang, Pui-Shan
and Christian, Judith",
title="Use of Teleconsultations in a Regional Stereotactic Radiosurgery Service: Pilot Study",
journal="JMIR Form Res",
year="2021",
month="Feb",
day="5",
volume="5",
number="2",
pages="e15598",
keywords="telemedicine",
keywords="teleconsultations",
keywords="brain metastases",
keywords="stereotactic radiosurgery",
keywords="mobile phone",
abstract="Background: The National Health Service Long Term Plan details plans to make digital interactions available to all patients in 5 years. Teleconsultations can improve access to specialist services; however, there is a lack of evidence for the use of teleconsultations in an oncology setting in the United Kingdom. Objective: We aim to describe a service evaluation of teleconsultations for patients attending a regional brain metastases clinic. These patients have unique travel restrictions that prevent them from driving. Methods: From April to October 2018, all patients attending the brain metastases clinic were offered the choice of teleconsultation in place of a face-to-face appointment. Feedback was assessed using a satisfaction questionnaire, and data of all clinic attendances were collected. Results: A total of 69 individual patients had 119 appointments over the duration of the pilot, of which 36 (30.2\%) were new patient appointments and 73 (61.3\%) were follow-ups. Of the 69 patients, 24 (35\%) took part in teleconsultations (41/119, 34.5\%). User satisfaction was high, and no patients who took part in a teleconsultation reverted to face-to-face appointments. These patients avoided 2521 miles (61.6 miles per appointment) of hospital-associated travel and travel costs of {\textsterling}441.48 (US \$599.83) to {\textsterling}10.78 (US \$14.65) per appointment. Conclusions: Teleconsultations appear to be acceptable in this cohort of patients with brain metastases attending a regional stereotactic radiosurgery service with the potential for significant savings in travel and expenses. ",
doi="10.2196/15598",
url="http://formative.jmir.org/2021/2/e15598/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33544082"
}


@Article{info:doi/10.2196/24222,
author="Levine, Hannun Oren
and McGillion, Michael
and Levine, Mark",
title="Virtual Cancer Care During the COVID-19 Pandemic and Beyond: A Call for Evaluation",
journal="JMIR Cancer",
year="2020",
month="Nov",
day="24",
volume="6",
number="2",
pages="e24222",
keywords="care",
keywords="patient-physician relationship",
keywords="patient-centered care",
keywords="oncology care delivery",
keywords="virtual visits",
keywords="telehealth",
keywords="virtual care",
keywords="cancer",
keywords="oncology",
keywords="evaluation",
keywords="COVID-19",
doi="10.2196/24222",
url="http://cancer.jmir.org/2020/2/e24222/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33180741"
}


@Article{info:doi/10.2196/21697,
author="Cancino, S. Ramon
and Su, Zhaohui
and Mesa, Ruben
and Tomlinson, E. Gail
and Wang, Jing",
title="The Impact of COVID-19 on Cancer Screening: Challenges and Opportunities",
journal="JMIR Cancer",
year="2020",
month="Oct",
day="29",
volume="6",
number="2",
pages="e21697",
keywords="cancer",
keywords="screening",
keywords="COVID-19",
keywords="coronavirus",
keywords="telemedicine",
keywords="social determinants",
keywords="health",
keywords="education",
keywords="training",
keywords="social media",
keywords="campaign",
keywords="branding",
keywords="cobranding",
doi="10.2196/21697",
url="http://cancer.jmir.org/2020/2/e21697/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33027039"
}


@Article{info:doi/10.2196/18835,
author="Waqas, Ahmed
and Teoh, Huat Soo
and Lap{\~a}o, Velez Lu{\'i}s
and Messina, Ary Luiz
and Correia, C{\'e}sar Jorge",
title="Harnessing Telemedicine for the Provision of Health Care: Bibliometric and Scientometric Analysis",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="2",
volume="22",
number="10",
pages="e18835",
keywords="telemedicine",
keywords="scientometric analysis",
keywords="evidence synthesis",
keywords="health information technology",
keywords="research",
keywords="theme",
abstract="Background: In recent decades, advances in information technology have given new momentum to telemedicine research. These advances in telemedicine range from individual to population levels, allowing the exchange of patient information for diagnosis and management of health problems, primary care prevention, and education of physicians via distance learning. Objective: This scientometric investigation aims to examine collaborative research networks, dominant research themes and disciplines, and seminal research studies that have contributed most to the field of telemedicine. This information is vital for scientists, institutions, and policy stakeholders to evaluate research areas where more infrastructural or scholarly contributions are required. Methods: For analyses, we used CiteSpace (version 4.0 R5; Drexel University), which is a Java-based software that allows scientometric analysis, especially visualization of collaborative networks and research themes in a specific field. Results: We found that scholarly activity has experienced a significant increase in the last decade. Most important works were conducted by institutions located in high-income countries. A discipline-specific shift from radiology to telestroke, teledermatology, telepsychiatry, and primary care was observed. The most important innovations that yielded a collaborative influence were reported in the following medical disciplines, in descending order: public environmental and occupational health, psychiatry, pediatrics, health policy and services, nursing, rehabilitation, radiology, pharmacology, surgery, respiratory medicine, neurosciences, obstetrics, and geriatrics. Conclusions: Despite a continuous rise in scholarly activity in telemedicine, we noticed several gaps in the literature. For instance, all the primary and secondary research central to telemedicine was conducted in the context of high-income countries, including the evidence synthesis approaches that pertained to implementation aspects of telemedicine. Furthermore, the research landscape and implementation of telemedicine infrastructure are expected to see exponential progress during and after the COVID-19 era. ",
doi="10.2196/18835",
url="https://www.jmir.org/2020/10/e18835",
url="http://www.ncbi.nlm.nih.gov/pubmed/33006571"
}


@Article{info:doi/10.2196/19322,
author="Lonergan, E. Peter
and Washington III, L. Samuel
and Branagan, Linda
and Gleason, Nathaniel
and Pruthi, S. Raj
and Carroll, R. Peter
and Odisho, Y. Anobel",
title="Rapid Utilization of Telehealth in a Comprehensive Cancer Center as a Response to COVID-19: Cross-Sectional Analysis",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="6",
volume="22",
number="7",
pages="e19322",
keywords="health informatics",
keywords="telehealth",
keywords="video visits",
keywords="COVID-19",
keywords="video consultation",
keywords="pandemic",
keywords="electronic health record",
keywords="EHR",
abstract="Background: The emergence of the coronavirus disease (COVID-19) pandemic in March 2020 created unprecedented challenges in the provision of scheduled ambulatory cancer care. As a result, there has been a renewed focus on video-based telehealth consultations as a means to continue ambulatory care. Objective: The aim of this study is to analyze the change in video visit volume at the University of California, San Francisco (UCSF) Comprehensive Cancer Center in response to COVID-19 and compare patient demographics and appointment data from January 1, 2020, and in the 11 weeks after the transition to video visits. Methods: Patient demographics and appointment data (dates, visit types, and departments) were extracted from the electronic health record reporting database. Video visits were performed using a HIPAA (Health Insurance Portability and Accountability Act)-compliant video conferencing platform with a pre-existing workflow. Results: In 17 departments and divisions at the UCSF Cancer Center, 2284 video visits were performed in the 11 weeks before COVID-19 changes were implemented (mean 208, SD 75 per week) and 12,946 video visits were performed in the 11-week post--COVID-19 period (mean 1177, SD 120 per week). The proportion of video visits increased from 7\%-18\% to 54\%-72\%, between the pre-- and post--COVID-19 periods without any disparity based on race/ethnicity, primary language, or payor. Conclusions: In a remarkably brief period of time, we rapidly scaled the utilization of telehealth in response to COVID-19 and maintained access to complex oncologic care at a time of social distancing. ",
doi="10.2196/19322",
url="https://www.jmir.org/2020/7/e19322",
url="http://www.ncbi.nlm.nih.gov/pubmed/32568721"
}