Telehealth in Cancer Care: Challenges and Opportunities for Equitable Access

The COVID-19 pandemic widened the digital divide in telehealth access in the United States. The future of telehealth remains uncertain, prompting questions about the next steps and the path forward. Over the course of several months, the Center for Health Law & Policy Innovation (CHLPI) of Harvard Law School engaged with a diverse group of cancer care stakeholders in New York State to understand challenges and explore policy opportunities for equitable access to telehealth in cancer care.

On May 14th, CHLPI presented key findings from this research during a webinar titled “Telehealth in Cancer Care: Strategies for Equitable Implementation in New York State.”

Dr. Francesca Gany, Founding Chief at Memorial Sloan Kettering Cancer Center, opened the webinar by addressing the “dramatic increase in the digital divide” during the COVID-19 pandemic. She highlighted results from a survey conducted at MSK Immigrant Health and Cancer Disparities Center, which showed that many communities during the pandemic lacked access to telehealth, which was deeply impacted by the lack of trust in the technology. Dr. Gany also discussed the critical role that the Bristol Myers Squibb Foundation’s Access to Telehealth for Underserved Breast Cancer Patients (AcT) program plays in bridging the telehealth access gap for breast cancer patients. 

The AcT program enhances access to care by providing telemedicine services, multilingual needs assessments, patient portal navigation, telehealth navigation, and telemonitoring for oncology, primary care, and mental health services. It also addresses essential needs such as food insecurity, housing, transportation, and legal services, and provides refurbished devices to patients in need.

CHLPI Clinical Instructor Rachel Landauer thanked every stakeholder for their helpful participation and highlighted core insights from the interviews for equitable telehealth implementation, including digital inclusion and equity issues such as broadband access, digital literacy, and insurance coverage concerns. She emphasized that telehealth challenges mirror broader healthcare system issues, including patient rights and protections like privacy and choice, and licensing barriers that impede community-based care. Despite cancer care being traditionally “high touch,” telehealth applications span various care settings and the care continuum.

CHLPI Clinical Fellow Sara Raza discussed two key insights: digital inclusion/equity and supporting providers within the New York policy landscape. For digital inclusion and equity, she identified opportunities such as digital health navigators, anchor institutions and community hubs, and the New York State Digital Equity Plan. In terms of supporting providers, Raza noted opportunities within Governor Hochul’s FY 2025 Executive Budget, which includes legislation for New York State to join the Interstate Licensure Compact and the Nurse Licensure Compact, which will make it easier for physicians and nurses licensed in other states to practice in New York and make it easier for New York providers to offer virtual care to their patients who travel to other states. 

Casey De Bellis, NYS Department of Health Program Research Specialist, provided insights into the New York State Medicaid Telehealth program and exciting opportunities such as e-Visits and e-Consults. She noted that Medicaid-covered services via telehealth include assessment, diagnosis, consultation, treatment, education, care management, and self-management. The program supports four telehealth modalities: audio-only, audio/visual, remote patient monitoring, and store-and-forward.

Future projects envisioned by the state include exploring new reimbursement mechanisms for telehealth across various settings, like remote patient monitoring in Federally Qualified Health Centers, publishing a comprehensive New York State Medical telehealth policy manual, and investigating additional telehealth modalities and benefits. 

Slides from this Webinar are available on the Dialogue4Health website.

Please see the webinar recording here.