ABSTRACT
In the last 2 years, the SARS-CoV-2 (COVID-19) pandemic demonstrated that rapid response to outbreaks with readily effective treatments represents a primary health and societal priority. At the same time, we became conscious that technological resources are often not used in the most efficient manner. The LIGATE and REpurposing MEDIcines For All (REMEDI4ALL) projects started on the large-scale mobilization efforts of the EXaSCale smArt pLatform Against paThogEns (Exscalate4Cov) project with the aim to apply cutting-edge technologies in drug discovery, sustain the fight against future pandemics, and promote the everyday fight against rare diseases. In particular, the LIGATE project, using the drug-discovery platform Exscalate, intends to boost the virtual screening of drug campaigns at an extreme scale in terms of performance and streamline the drug-development process. The aim of the REMEDI4ALL project is to collect sciQ1entific expertise and innovative technology platforms for the repurposing of medicines to treat rare diseases or other pathologic conditions with no current therapy. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Background: In response to the COVID-19 pandemic, telehealth has emerged as a key strategy to ensure the safety of patients and healthcare workers and minimize disease spread. Lyndon B. Johnson Hospital (LBJ) is a safety-net hospital that mainly serves low income and uninsured patients (pts), and MD Anderson Medical Oncology faculty and fellows diagnose and treat over 800 new cancer cases per year in the LBJ Oncology Clinic. We piloted a teleoncology (TO) program to replace inperson visits for pts with clinic appointments (appts) during the COVID-19 pandemic. Methods: A multidisciplinary team was formed to implement TO in the LBJ Oncology Clinic. Fellows and APPs screened their appts in advance and used guidelines to determine pts appropriate for TO. Clinic visits were prioritized for new pts, treatment consents, and symptomatic pts;stable pts on treatment and surveillance had appts changed to TO. Pts were notified when their appts were converted, with integrated video visits preferred over telephone visits. To limit disease exposure, 3 fellows rotated in clinic for one week at a time and cared for the pooled clinic pts;the other 16 fellows and 2 APPs conducted TO and remotely staffed their pts with faculty on their assigned clinic day. We reviewed TO visits during the initial 1-month pilot period and survey results from involved personnel. Results: From 4/13/2020-5/8/2020, we identified 251 pts that utilized TO. Median age was 57 years (range, 20-88) and 66% were female;63% were Hispanic and 21% were African American;52% spoke Spanish and 46% spoke English. 57% of TO visits were conducted via telephone and 43% via video. 48% of the TO visits were for pts on active treatment, including IV therapy (35%) and oral targeted agents (13%);15% were surveillance pts with (9%) or without (6%) restaging imaging, 8% were pts on endocrine therapy, and 16% had transitioned to the Survivorship Clinic staffed with APPs. Survey response rate was 100% (5/5) for faculty, 74% (14/19) for fellows, and 100% (2/2) for APPs. 80% of faculty, 57% of fellows, and 100% of APPs were generally satisfied (agree/strongly agree) with the patient care delivered via TO;100% of faculty, 64% of fellows, and 100% of APPs believe patients were generally satisfied with TO. Conclusions: This study demonstrates that implementing TO in a fellows' teaching clinic at a safety-net hospital is feasible and effective. Nearly half of the TO visits conducted during this pilot period were for pts on active cancer treatment and the majority of caregivers were satisfied with TO. Pt care via TO is ongoing and pt survey data is currently being collected.