Tag Archive for: in-person visits

What Is the Role of AI in Telemedicine for MPNs?

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What Is the Role of Artificial Intelligence (AI) in Telemedicine for MPNs? from Patient Empowerment Network on Vimeo.

How does artificial intelligence (AI) fit into the myeloproliferative neoplasm (MPN) care toolbox? Dr. Kristen Pettit from Rogel Cancer Center explains the current role of AI, her hopes for the future of MPN care, and what she considers the ideal model for MPN care.

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Transcript:

Dr. Kristen Pettit:

I think the role of artificial intelligence and telemedicine in MPN fields is going to be evolving over the next few years. I think one thing that will be very interesting that I’m very interested in seeing is whether we’re able to incorporate things like data from wearable devices, for example, like your Apple Watch or those sorts of devices directly into your healthcare to be able to monitor you on a more continuous basis and virtually, I think more things of that nature will be coming over the next couple of years.

I think that incorporating telemedicine into MPN monitoring is a relatively safe thing to do for most patients, very rarely things will come up in an in-person visit that might not have been reported or caught on a telemedicine visit, for example, slight changes in spleen size that we may be able to feel in the office that might not be symptomatic to the patient at home or might not be noticed at home could happen. Other things like weight loss that a person might not necessarily have noticed at home, but that we would hopefully pick up on it.

An office visit might be another thing to think about, but both of these situations, I think are relatively uncommon, I think the most important thing is for a patient and their family members to know their body, know their symptoms, keep an eye out for any changes, while they’re at home, and as long as that’s being done, really, I think telemedicine is relatively safe to incorporate in MPN care. Ideally, I think that would be done sort of intermittently or alternating between virtual visits and in-person visits with an individual patient.

What Role Does Telemedicine Play in Acute Myeloid Leukemia Care?

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What Role Does Telemedicine Play in Acute Myeloid Leukemia Care? from Patient Empowerment Network on Vimeo.

In acute myeloid leukemia (AML) care, how can telemedicine be used? Watch as expert Dr. Catherine Lai shares different situations where telemedicine has served as a helpful tool and instances when in-person visits are optimal for patient care.

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What Role Does a Multidisciplinary Team Play in AML Care? 

Transcript:

Sasha Tanori:

My care team suggested a clinical trial for a new drug focusing on improving my lung function, fortunately, my lungs improved on their own. Dr. Lai, not every AML patient is offered a clinical trial as a care option, what advice do you have for AML patients who are seeking clinical trials, and what’s the best way to locate one?

Dr. Catherine Lai:

Yeah, so this is an area, a huge area of unmet need, I would say in general, across all oncology trials, and I think less than 10 percent of the patient population is on trials, there’s a lot of stigmas around clinical trials and are you getting…are you getting a drug that we don’t know what’s going to work, am I being…am I being tested? In oncology, I would say for the most part, we try to make trials where you’re being measured to the standard, so you’re getting the standard plus, or we’re trying not to…just in terms of doing what’s best for the patient, in general, I don’t offer trials to patients where I don’t think that there’s scientifically a rationale for those drugs, but to answer your question, the best place to look is on clinicaltrials.gov. That’s cumbersome. If you don’t know what you’re looking for, I can give you a lot of unnecessary information. There are a lot of other resources out there, The Leukemia & Lymphoma Society is a great resource. I know that they have online or people that you can talk to in terms of helping you direct specific clinical trials, I know depending on where you live in the country, there are other local new chapters, oncology chapters that we have that can help patients find…

And have access to clinical trials, and then I think the biggest thing is just if a patient is with the community oncologist, having enough education to say, can I have a referral to an academic institution where they can ask those questions and get that information, and local community oncologists are fantastic, but they see everything, they see breast cancer, they see one cancer where the academic centers were specialized where all I see is leukemia and MDS kind of acute leukemias. So, it’s just a different set of knowledge.

MPN Patient and Care Partner Tips for Utilizing Telemedicine

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MPN Patient and Care Partner Tips for Utilizing Telemedicine from Patient Empowerment Network on Vimeo.

Myelofibrosis patient Summer Golden and care partner Jeff Bushnell have learned the ins and outs of telemedicine. Watch as they share some advantages of virtual visits, instances when in-person visits are used for MPN monitoring, and their tips for optimizing telemedicine visits.

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Transcript:

Jeff Bushnell:

We are very fortunate to live in San Diego here where there are major medical centers and research universities and so on, but a lot of people aren’t… and these MPNs are very, very rare diseases. And there are not a lot of doctors that specialize in them, so telemedicine will allow you to contact a specialist.

I know when we see the Summer’s doctor in-person, she does a physical exam specifically to check her spleen size, which is an important aspect of almost all of these MPNs and without the ability to do that the doctor is working all solely from blood counts.

Summer Golden:

It’s just like Zoom, it’ll never go away, and I do believe telemedicine will be here forever, another technical advantage.

Jeff Bushnell:

I think, especially after COVID, people are more used to telemedicine, and in the MPN community anyway, because of the lack of large numbers of doctors that know much about it, like telemedicine will open up sort of a new, a new type of being able to treat MPNs, just because more people will be able to contact specialists.

Summer Golden:

A top tip I think, it’s sort of logical, but is to have the questions and issues written out because it’s a limited matter of time and to specifically jot down the answers.

Jeff Bushnell:

Another tip would be to ensure that you have the appropriate stuff on whatever device you’re using to talk to the doctor on. We’ve used about three or four different apps as it were on our phone to communicate with different doctors, and you need to make sure that that works ahead of time. Usually, the way they do it is they set up the appointment, they contact you ahead of time, and make sure that it’s going to work before they put the doctor online. But that’s very important that you have the technical ability to ensure that your equipment can support telemedicine. They’re making it pretty easy, but you still have to do it.

Do Telephone-Only Visits Qualify As a Telemedicine Visit?

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Do Telephone-Only Visits Qualify As a Telemedicine Visit? from Patient Empowerment Network on Vimeo.

For head and neck cancer patients, do telephone-only visits really qualify as a telemedicine visit? Watch as expert Dr. Samantha Tam from Henry Ford Health System explains care concerns that can be covered in telephone versus video visits – and patients who can benefit from the use of virtual visits. 

See More From The Head & Neck Cancer TelemEDucation Empowerment Resource Center

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Transcript:

Samantha Tam, MD, FRCSC, MPH: 

So from a… Telephone-only visits have a lot of drawbacks to them, I think even virtually assessing a patient with regards to how they’re doing generally, a general physical examination is very important. On top of that, we have a lot of sensitive conversations in patients that have head and neck cancer, so it’s important to also read things like non-verbal body language, so definitely the video component is extremely useful for providers that are caring for patients with head and neck cancer. However, in patients that might not have access to video visits, might not have the technology, I think that the number one priority in our minds is that this patient gets the best care that they are able to get, and whether that this means a telephone-only type of a visit is possible for these patients, we adjust our…I guess we adjust our requirements, we adjust our ability to deliver care based on that, so that might mean touching base with the patient on the phone at first in order to understand exactly what they’re going through, talk them through the next steps so that they know what to accept in order to make their care more streamlined later on. I don’t think that telephone visits will completely replace either virtual visits or in-person visits, but I think that, again, they are a tool, and they’re a tool that especially patients that might be more disadvantaged, such as not having access to good Internet might not have access to the technology required for a virtual visit, those patients need to be considered when we consider utilizing telephone-only care. 

Is Telemedicine a Mainstay for Head and Neck Cancer Patients?

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Is Telemedicine a Mainstay for Head and Neck Cancer Patients? from Patient Empowerment Network on Vimeo.

Will head and neck cancer care continue with telemedicine in the future? Watch as expert Dr. Samantha Tam from Henry Ford Health System shares her perspective on her expectations for the use of telemedicine versus in-person visits with head and neck cancer patients.

See More From The Head & Neck Cancer TelemEDucation Empowerment Resource Center

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Transcript:

Samantha Tam, MD, FRCSC, MPH: 

So while COVID-19 has forced us into utilizing telemedicine in context that we might not nearly have used them in the past, I think that telemedicine is here to stay, though perhaps not as wide spreading universal as it has been at the beginning of the pandemic. Telemedicine to me, seems to be a very good adjunct to our in-person visits, I think seeing patients and evaluating them in-person is essential in head and neck cancer throughout the treatment course. That being said, I think that telemedicine really adds a value into patient’s care, there are several ways that we have used this at Henry Ford in order to enhance access to our services, one is with patient intake, when we have some information, we can certainly start to…we can meet with you, get a good clinical history and understand exactly what is going on, and therefore expedite investigations that are required, and then condense our visits to just one in-person visit versus multiple in-person visits. Another way that I have used this is checking in with patients while they’re in the middle of treatment, sometimes patients are getting daily radiation, not close to my office, but I like to check on them to make sure from a symptom standpoint that they’re tolerating their treatment well. 

And certainly coming down for a visit would be impossible, so checking in with them virtually has been a good way to monitor treatment side effects and to ensure everything is going smoothly from that standpoint. With surveillance, there have been also options that way to check in with patients that are more on the survivorship end of things to see how things are going that way though, I often do like to see patients in follow up in-person just so that we can also complete an endoscopic examination as clinically indicated.  

How Has the Pandemic Reshaped Head and Neck Cancer Care?

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How Has the Pandemic Reshaped Head and Neck Cancer Care? from Patient Empowerment Network on Vimeo.

How has head and neck cancer care changed from the COVID-19 pandemic? Watch as expert Dr. Samantha Tam from Henry Ford Health System shares situations for in-person vs. telemedicine visits.

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Transcript:

Samantha Tam, MD, FRCSC, MPH: 

COVID-19 has significantly changed how healthcare is delivered to patients with head and neck cancer. Traditionally head and neck cancer care has been delivered in-person visits because patients with head and neck cancers are often difficult to examine on a virtual platform, and on top of that, many patients have difficulties with communication, just given the ramifications of the disease. However, with COVID-19, we had a conscious effort to shift a lot of our care from in-person to virtual visits, and the area of telemedicine has been therefore greatly expanded in patients with head and neck cancer diagnosis. How head and neck cancer patients have been able to utilize telemedicine has been varied according to whether or not these patients are coming in for new diagnoses for follow-up care, for post-op diagnoses or for care during their treatment. And I feel that virtual care is really complementary as opposed to a substitute for patients with head and neck cancer because certainly there are innate difficulties in communication through the virtual platforms, as well as innate difficulties with examining patients adequately through the virtual platform. 

That being said, there’s a lot of care, for example, with allied health professionals, or surveillance care that can be completed on a virtual platform that may use healthcare delivery to patients that may not be able to access in-person care on a regular basis 

Will Telemedicine Be an Equalizer for Patients Experiencing Bias?

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Will Telemedicine Be an Equalizer for Patients Experiencing Bias? from Patient Empowerment Network on Vimeo.

Some breast cancer patients may experience in-person bias during visits. Expert Dr. Regina Hampton from Luminis Health Doctors Community Hospital explains her perspective on situations when telemedicine can provide benefit to the patient experience.  

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Transcript:

Dr. Regina Hampton:

Yeah, I think it takes away that, that in-person bias that that providers may have, you can kind of put on whatever you want and put on your face, and then I think that gives some providers just a different view of who that person is without looking at them in-person. And creating that judgment that we all do, we all do it, and that’s just a part of human nature. But I think it’s great for those patients who…I have a lot of patients who are caregivers where they’re caring for their elderly patient, and they can’t leave that patient alone. Well, they can continue to do their doctor’s visit provided they don’t need a physical exam and be able to keep that. It may be helpful for that patient who is stuck at home, it allows them that access. So I think it does help to decrease the barriers, especially for patients who may live in a rural area, who may not be able to travel back and forth to the big city to see their doctor, and being able to jump on a telemedicine visit to be able to get their concerns heard, and then they can figure out if they need an in-person visit, so I think it’s just going to open up the world. 

I think it will give those patients more access, and hopefully it will help to just break down some of these barriers that we see as we move forward. 

Is Telemedicine an Advantage for Low-Risk Breast Cancer Patients?

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Is Telemedicine an Advantage for Low-Risk Breast Cancer Patients? from Patient Empowerment Network on Vimeo.

 For low-risk breast cancer patients, is telemedicine an advantage? Expert Dr. Regina Hampton from Luminis Health Doctors Community Hospital shares her views on when telemedicine makes sense for low-risk patients and the benefits she’s seen for patients’ quality of life.

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Transcript:

Dr. Regina Hampton:

I think it helps to eliminate a lot of those in-person visits, which then means they can enjoy life. We want them to enjoy life after surviving their breast cancer diagnosis and treatment. So maybe they’re doing their televisit while they’re on vacation or while they’re out of the state, visiting with relatives. So it really allows them to be able to stay in tune and in touch with their healthcare providers, stay on top of their visits, but allow them the flexibility to continue to live life. I often tell patients, “Look, after we’ve treated you, we don’t want you in our offices all the time. We want you out there living life.” And if we can make that easier by doing a quick tele visit, especially if there’s not something serious going on, then I think that’s a great advantage. And I think as we move deeper and deeper into the telemedicine world, I think patients are going to appreciate that, and they’re going to actually demand it and say, “Well, you know, I’m doing fine, I just need you to look at my mammogram and us to have a quick discussion while on a cruise or while I’m on the beach in Hawaii enjoying some time with my family.” So, I think it’s opened up a new world, and it’s just going to get better and more easy, and I think patients are going to shift their brains to say, “You know, if I don’t have to be in an office somewhere, I’d rather be on a video or a phone visit.

Which Breast Cancer Patients Benefit Most From Telemedicine Visits?

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Which Breast Cancer Patients Benefit Most From Telemedicine Visits? from Patient Empowerment Network on Vimeo.

Dr. Regina Hampton  from Luminis Health Doctors Community Hospital provides her perspective on care situations when patients can benefit the most from telemedicine – and when in-person visits can provide an advantage.

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Transcript:

Dr. Regina Hampton:

So, I think when we look at new patients, newly diagnosed, I think an in-person visit is certainly advantageous, I think people certainly want to meet their doctor in-person, what I found personally is after that initial visit, then we’ll convert the rest of the visits by telemedicine. As the patient is willing, if they want to come in, I’m happy to have them come in, where I think it’s really beneficial is in survivorship after the patient has gone through treatment, and she may still be following with her medical oncologist, because she’s on hormonal therapy. Or she may be on some form of chemotherapy, and maybe she wants for me to be able to take a look at her mammogram. Well, I can still do that because I can remotely access those films, and then we could do that television, and if she’s not expressing any concerns, then we can do that as a television, so this helps, especially for those patients in survivorship where they’re not going to three and four different doctors on a regular basis. They’re going to that one doctor, they’re getting that in-person visit, and then some of the other providers are part of the team can maybe move theirs to telemedicine visits, so again, I think it helps to keep patients with that connection to some of those without again, having the burden of taking time off of work, having to arrange childcare, they can do those other visits by telemedicine. And that’s something new that we weren’t doing pre-COVID, patients were having to come into the office and see every single provider for every six months for the first two to three years after their diagnosis, so I think that really has made it more convenient for the patients, and it’s really allowed us to really streamline our operations on the provider side, which then allows us to be able to serve more patients.  

How Will Telemedicine Impact Multiple Myeloma Clinical Trials?

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How Will Telemedicine Impact Multiple Myeloma Clinical Trials? from Patient Empowerment Network on Vimeo. 

What impact has telemedicine had on multiple myeloma clinical trials, and what effect will it have on trials in the future? Expert Dr. Joseph Mikhael explains the impact of telemedicine early on in the COVID-19 pandemic, how he uses virtual visits with his patients currently, and the role and benefits of telehealth in the future of myeloma care.

See More From the Myeloma TelemEDucation Empowerment Resource Center

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Are There Any Barriers for Multiple Myeloma Patients Using Telemedicine?

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Transcript:

Dr. Joseph Mikhael:

COVID-19 has impacted our lives in just about every way imaginable, and in multiple myeloma, sadly has very much impacted our ability to conduct clinical trials. Thankfully, now that we are out of the immediate acute phase when many trials were suspended, we actually have been able to work around this in general, where now we’ve been able to re-introduce studies and bring in new studies, of course, and we can do so in a more careful manner. Many of our clinical trials now are allowing intermittently to have telemedicine visits, which reduces the traffic for patients and makes it a little bit smoother. Some of the questionnaires and the things that we used to have to fill out on paper or physically in-person now can be done electronically, and so I think in many respects, we’ve really overcome most of the barriers so that we can continue the outstanding work and clinical trials to provide options for our patients that were not available before.

And looking to the future, I hope, even paradoxically in some way that this may — now that we’ve developed a more sophisticated telemedicine platform — it may allow us to do more and perhaps reach patients that may not have been reached before, there are already studies and trials that are being done through telemedicine, not necessarily a drug trial but quality of life studies, engagement studies, educational studies, different ways that we can enhance a patient’s experience and investigate better ways of doing things now that we can do so more fully electronically.

So, when I think of telemedicine and the future in multiple myeloma, I think it will continue to have a role in the long term. I think, much like people think that there will be more virtual meetings, I think we all want to get back to in-person meetings of various types and sizes and shapes, there will always be a component of virtual, and I can think even in my own practice and some patients that have quite a long drive to come down to see me, that they will still have to have face-to-face visits, but intermittently when the things are going well, follow-up like visits where the discussion may be limited.

I think there will be a role for this so that we can leverage the best of telemedicine and the best of in-person medicine so that the patients can receive the best care possible.

What Multiple Myeloma Populations Will Benefit From Telemedicine?

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What Multiple Myeloma Populations Will Benefit Most From Telemedicine? from Patient Empowerment Network on Vimeo. 

Which multiple myeloma patients will benefit most from telemedicine visits, and which patients can get more from in-person visits? Dr. Joseph Mikhael shares information on how to ensure the best myeloma care even during pandemic restrictions and how in-person visits have adjusted to limit COVID exposure risk.

See More From the Myeloma TelemEDucation Empowerment Resource Center

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Are There Any Barriers for Multiple Myeloma Patients Using Telemedicine?

What Are Best Practices for Multiple Myeloma Patients Utilizing Telemedicine?

How Will Telemedicine Impact Multiple Myeloma Clinical Trials?
 

Transcript:

Dr. Joseph Mikhael:

When it comes to making a decision around, do I need to go into the clinic or can I do this as a telemedicine visit, of course, that has to be discussed with the healthcare team, but a few things we’ve learned through this pandemic.

And perhaps one of the most important things we’ve learned through the pandemic is that controlling one’s disease, controlling one’s myeloma is critical to protecting people against COVID, sadly, many of our patients who have struggled the most with COVID are those who had very active myeloma. So, we emphasize the importance of making sure that one continues to receive the best myeloma care possible, and very often that is going to involve an in-person visit, not only for discussion, but, of course, for the actual receiving of treatment. Secondly, I think it’s very important for us to note that we really have not seen significant spread of COVID or almost any infection within our hematology-oncology clinics, we’ve taken particular precaution around this area. So, this is different than someone maybe going out to a more public place where the risks may be higher. And so, we try to reassure our patients that coming into clinic actually is really not a high-risk situation and, in fact, perhaps lower risk than ever in light of the fact that many of our waiting areas and places where we have patients have been restructured and have fewer patients because of telemedicine visits.

And then thirdly, and very importantly, whether it’s telemedicine or in-person, it’s really important to maintain open, honest, and clear communication with the healthcare team. And if that is felt that it’s being done to a certain extent in telemedicine, fantastic, but there are situations where it’s challenging and difficult and really must be face-to-face. And so I would want to encourage my patients not to be afraid to go in to receive treatment and to meet with their healthcare team. These are generally very safe places that we take special precautions to ensure their patients can receive the best care possible.