Guidelines for teleconsultations

ABSTRACT

Introduction: The COVID-19 pandemic forced oncology nurses to deliver more consultations by telephone (teleconsultations). Nurses in Switzerland are in general not trained to provide teleconsultations, making this change of practice a considerable challenge. The Academic Society Oncology Nursing invited health care professionals to webinars in French and German to discuss their experiences related to COVID-19 policies. Method(s) Members of the Academic Society searched for international guidelines and already implemented digital tools to facilitate teleconsulta-tions in oncological settings. Overall, ten national and international health care experts including nurses, an oncologist, and an expert for telephone consultations participated at two webinars. The same outline was used in French and German and both webinars were video recorded. Result(s) COVID-19 pandemic policies drove an increase in teleconsulta-tions. Guidelines for telephone triage from the Oncology Nursing Society (ONS) in the USA and in the UK (UKONS) incorporated procedures to assess COVID-19 symptoms and to defne patient referrals based on local health system capacities. In France, the Gustave Roussy Institute created the CAPRI-COVID program to facilitate the remote monitoring of cancer patients during the COVID-19 pandemic. In Switzerland, nurses used local guidelines implemented for follow-up consultations by telephone to support cancer patient adherence to treatment and to assess symptom trajectories, to structure their teleconsultations. The assessment of COVID-19 symptoms was not always included. The sudden change to support patients remotely was challenging when no guidelines or standards for this kind of support were already in place. Documenting tele-consultations was difcult when no electronic documentation system was implemented. The reimbursement of nursing teleconsultations was a major, important barrier nurses faced, leading to unpaid provided services. Conclusion(s) The federal health system in Switzerland has provided no national recommendations for nursing teleconsultations. However, ONS and UKONS guidelines could inform the development of evidence based recommendations for oncology nursing teleconsultations in Switzerland. The Academic Society Oncology Nursing will take an initiative to discuss reimbursement of nursing teleconsultations with Swiss stakeholders including health care professionals and policy makers.