Virtual Visits in Oncology: Enhancing Care Quality While Designing for Equity

Abstract

Despite recent gains in cancer outcomes, populationsat risk of health inequities—including Black Ameri-cans and those residing in rural areas—continue toexperience worse cancer outcomes.1-5Although theetiology of this widening gap is complex, the importanceof structural barriers is increasingly understood.1,6,7TheCOVID-19 pandemic fundamentally changed oncologypractice by placing virtual visits—real-time telephone orvideo encounters—centrally within outpatient cancercare.8-10Most expect virtual care to persist whenever thepandemic subsides. It, therefore, is imperative that weconsider how virtual care can enhance quality andoutcomes and, importantly, not exacerbate knowndisparities. Herein, we draw from invited remarks de-livered to the Centers for Medicare & Medicaid ServicesLessons from the Front Lineseries11to summarize thepotential benefits of incorporating virtual visits, describehow (in the absence of purposeful planning) they mayexacerbate inequities, and provide examples of howvirtual oncology programs can be designed to enhanceequity.