Patient education is one of our core missions: you deserve to know everything that is developing in the healthcare landscape and why it’s important. Recently, in the journal PLoS One, researchers analyzed telehealth provisions and oncological services available in hospitals throughout the United States before the onset of the coronavirus disease 2019 (COVID-19) pandemic, in addition to examining the sociodemographic and geographic correlates of telehealth access. It was found that 8.4% of the population does not have access to proper cancer care due to geographic barriers.

The United States is unequivocally the hub of advanced healthcare, but in no way are these innovative technological advancements spread evenly over the country. Cancer patients residing in the rural United States experience hindered access to all phases of quality healthcare, especially compared to the healthcare services available to urban cancer patients. This is primarily because of geographical constraints that impede access to high-quality, personalized oncological care.

Such geographical barriers are known to significantly reduce the chances of proper treatment for patients with colon, lung, breast, esophagogastric, rectal, and gynecological cancers. Thus, the provision of proper cancer-related treatments and the culmination of the pursuit of equity in cancer care is a dream yet to come true, primarily because of the lack of adequate geographical distribution of access points for high-quality cancer care.

A substantial difference exists between the cancer patient populations requiring cancer care and the distribution of oncology specialists in various locations. Advanced cancer centers are typically built in high-volume regions, primarily because of the enhancement in outcomes that comes hand in hand with treatment in such centers. Cancer patients in rural areas, thus, have to undertake arduous journeys to reach facilities that can provide high-quality cancer care.

The Role of Telehealth in Cancer Care

A Study Telehealth is crucial in a healthcare topography depicting such cancer care disparities to decrease the growing gap between rural and urban healthcare provision. Rural patients can benefit from referral centers that provide telehealth outreach in areas where residents may face difficulties reaching the nearest healthcare center. Telehealth offers a highly advantageous platform for augmented geographical outreach regarding community cancer practices. It also allows oncologists to connect with other professionals in the field to allow patients the benefits of subspecialty cancer care without traveling extensively.

The above-mentioned scenario is the basis of this study and undertakes a national analysis of the oncologic and telehealth services offered by hospitals before the Covid-19 pandemic, keeping the geographical and sociodemographic factors into consideration. This cross-sectional analysis was conducted through Geographic Information Systems mapping of three prominent domains, including the following:

• The 2019 American Hospital Association (AHA) Annual Hospital Survey and IT Supplement
• The 2013 Urban Influence Codes (UIC) from the United States Department of Agriculture
• The 2018 Area Health Resources Files from the Health Services and Resources Administration (HRSA).

The AHA is an annual survey that gathers information on various hospital characteristics, including the following:
Hospital geographic coordinates

• Telehealth adoption
• Payer mix for Medicare and Medicaid
• Oncology services
• Commission on Cancer Accreditation status
• Hospital ownership
• Teaching status
• Number of staffed beds
• Accreditation status by Joint Commission or DVN
• System affiliation

The 2019 AHA survey had a 75.1% response rate for hospital data that failed to respond to telehealth questions, historic data from 2015-2018, and the 2019 AHA IT Supplement was imputed. The hospital facilities were divided according to their oncology and telehealth service availability. In contrast, counties were categorized as low, moderate, or high access on the basis of high-quality hospital-based telehealth and oncology services available in their boundaries.

Outcomes of the Study

This study was conducted for geospatial mapping of quality access to hospital-based telehealth for cancer patients. An analysis of generalized logistic mixed effects models offered insight into connections between sociodemographic factors and county and hospital-level access to oncology care and telehealth. The two primary outcomes of this cross-sectional study are as follows:

• Availability of hospital-level oncology services
• Availability of hospital-level telehealth

The hospital-level telehealth availability was derived from the AHA survey, which offered information through the responses of each hospital regarding whether they owned or provided telehealth services for office visits and consultation in their healthcare settings. The availability of hospital-level oncology services, in contrast, was identified through an elaborate study of the survey responses on whether a hospital offered on-site “inpatient and outpatient services for patients with cancer, including comprehensive care, support and guidance in addition to patient education and prevention, chemotherapy, counseling, and other treatment methods.”

Results and Conclusions

The results of the study were as follows:

• Around 2,054 out of 4,540 hospitals (which comes up to 45.2%) reported both telehealth and oncology services
• 272 hospitals (6.0%) offered oncology without telehealth
• 1,369 hospitals (30.2%) offered telehealth without oncology
• 845 (18.6%) hospitals offered neither

Out of a total of 3,152 counties housing 26.6 million residents across 41 states, 1,288 had no hospital-based access to either telehealth or oncology. Rural hospitals were even less likely to offer telehealth services in collaboration with oncology care than urban hospitals (OR 0.27; 95% CI 0.14–0.55; p < .001). The study found no significant county-level factors associated with telehealth availability in hospitals offering oncology care.

Thus, the study concluded that although telehealth and hospital-based cancer care is widely available in the US, 8.4% of cancer patients are at risk because of geographical barriers that hinder quality access to both.