Defining the Current Landscape, Attitudes, and Perceived Barriers of Virtual Medicine in Underserved Populations.

PURPOSE: Virtual medicine (VM) use increased during the COVID-19 pandemic as it represented a safe alternative to traditional face-to-face health care delivery. This prospective cross-sectional study aimed to characterize preferences and perceived barriers to VM on the basis of language and specific sociodemographic variables while also identifying particular subpopulations at risk of dissatisfaction regarding VM. METHODS: An institutional review board-approved, 23-item questionnaire was offered in English and Spanish. Examined variables included demographic information, preferences, and perceived barriers regarding VM. Multivariable analysis was performed to determine the association between demographic variables and participants' preferences and perceived barriers. RESULTS: Fewer Hispanic and underserved patients (N = 241) had received oncological care through VM (28.9% v 30.8%) despite comparable preferences and levels of satisfaction regarding the incorporation of VM in health care delivery (21.6% v 25.4%; 68.7% v 82.1%), respectively, with no significant difference by age, level of education, marital status, or Hispanic ethnicity, although Spanish as primary language was statistically significant (P = .001). Although Hispanic and underserved rely more on social media to receive health information (26.5% v 24.7%), they have more technical barriers. They were up to 2.9 times more likely not to have a phone/iPad/similar or access broadband connectivity. CONCLUSION: Given the shift toward outpatient and home-based care, an aging population, and cultural appropriations, VM excitedly allows the reincorporation of family/caregiver in medical engagement. Hispanic patients are equally interested and satisfied in receiving oncological care through VM, but fewer are currently using it. Barriers are predominantly technical and targetable with appropriate policies to help overcome technological barriers on the basis of language, ethnic, locoregional, and sociodemographic variables.

HOLA COVID-19 Study: Evaluating the Impact of Caring for Patients With COVID-19 on Cancer Care Delivery in Latin America.

PURPOSE: The HOLA COVID-19 study sought to evaluate the impact of COVID-19 on oncology practices across Latin America (LATAM), challenges faced by physicians, and how practices and physicians adapted while delivering care to patients with cancer. METHODS: This international cross-sectional study of oncology physicians in LATAM included a 43-item anonymous online survey to evaluate changes and adaptations to clinical practice. Multivariable logistic regression analyses were used to evaluate the association of caring for patients with COVID-19 and changes to clinical practice. RESULTS: A total of 704 oncology physicians from 19 countries completed the survey. Among respondents, the most common specialty was general oncology (34%) and 56% of physicians had cared for patients with COVID-19. The majority of physicians (70%) noted a decrease in the number of new patients evaluated during the COVID-19 pandemic when compared with prepandemic, and 73% reported adopting the use of telemedicine in their practice. More than half (58%) of physicians reported making changes to the treatments that they offered to patients with cancer. In adjusted models, physicians who had cared for patients with COVID-19 had higher odds of changing the type of chemotherapy or treatments that they offered (adjusted odds ratio 1.81; 95% CI, 1.30 to 2.53) and of delaying chemotherapy start (adjusted odds ratio 2.05; 95% CI, 1.49 to 2.81). Physicians identified significant delays in access to radiation and surgical services, diagnostic tests, and supportive care. CONCLUSION: The COVID-19 pandemic has significantly disrupted global cancer care. Although changes to health care delivery are a necessary response to this global crisis, our study highlights the significant disruption and changes to the treatment plans of patients with cancer in LATAM resulting from the COVID-19 health care crisis.