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Access, Utilization and Outcomes of Cancer Services in the Era of Telemedicine

Award Number: R01CA267990
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/01/2022
PERIOD OF PERFORMANCE END DATE: 01/31/2027

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Access, Utilization and Outcomes of Cancer Services in the Era of Telemedicine - Use of telehealth has skyrocketed since the start of the COVID-19 pandemic. Pre-pandemic, only 60,000 of the 63 million fee-for-service Medicare beneficiaries received a telehealth service each month compared to 24.5 million from March to October, 2020, with wide geographic variation in that uptake (e.g. 8.4% in South Dakota to 47.6% in Massachusetts). This telehealth expansion comes at a time when the often-severe access issues for rural individuals have become a focus for health policy and access. Longer travel times for rural cancer patients have been shown to negatively impact treatment regimens, RCT participation, and symptom management. Multi-specialist teams are often required for comprehensive cancer care, making care coordination in rural areas particularly challenging. These barriers have contributed to the widening gap in cancer mortality between rural and urban patients. Measuring access to cancer care is a fundamental component of both identifying gaps in access, as well as developing models to improve care delivery. Because telehealth transcends geographic proximity, it holds great promise for addressing rural cancer care access challenges. Telehealth allows specialists to connect with geographically distant patients and providers who otherwise would have had more restricted options for referral. With the expected persistence of expanded telehealth following the COVID-19 pandemic, the time is now to develop new ways to measure access to cancer care that integrate geospatial measures with telehealth and referral patterns in order to improve health care access and outcomes. Telehealth is now integral to rural cancer care in some regions, yet where gaps are in its use and how barriers in access impact utilization and outcomes is unknown. Only by measuring the new reality of cancer care access that includes telehealth, understanding telehealth impacts on outcomes, and applying this evidence to “what if” scenarios/projections, can we begin to harness and proactively direct the potential that telehealth has to reduce rural cancer disparities. This study will take the critical and timely steps of developing measures of access nationally that incorporate telehealth, identifying determinants of telehealth use in cancer care, testing effects of telehealth on cancer outcomes, and analyzing the projected impact on access in cancer care access and outcomes if telehealth use in cancer is expanded, while considering differential effects based on the rural-urban continuum. To do this, we will use national Medicare claims for telehealth utilization among cancer patients, Federal Communications Commission (FCC) broadband data, and 2020 Census data for the entire U.S., to extend our prior geospatial cancer care access work (R21CA212687) and population-based outcomes modeling with policy relevance.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $323,658 )
2026	2026	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Cancer Cause and Prevention Research	000	5	2/12/2026	NON-COMPETING CONTINUATION	$323,658
														Subtotal = $323,658

Issue Date FY: 2025 ( Subtotal = $360,206 )
2025	2025	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Cancer Cause and Prevention Research	000	4	1/28/2025	NON-COMPETING CONTINUATION	$324,186
2025	2025	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Cancer Cause and Prevention Research	001	4	5/28/2025	NON-COMPETING CONTINUATION	$36,020
														Subtotal = $360,206

Issue Date FY: 2024 ( Subtotal = $344,165 )
2024	2024	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Cancer Cause and Prevention Research	001	3	4/17/2024	NON-COMPETING CONTINUATION	$18,114
2024	2024	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Cancer Cause and Prevention Research	000	3	1/10/2024	NON-COMPETING CONTINUATION	$326,051
														Subtotal = $344,165

Issue Date FY: 2023 ( Subtotal = $354,662 )
2023	2023	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Cancer Cause and Prevention Research	000	2	3/20/2023	NON-COMPETING CONTINUATION	$354,662
														Subtotal = $354,662

Issue Date FY: 2022 ( Subtotal = $386,572 )
2022	2022	UNIVERSITY OF UTAH, THE	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Cancer Cause and Prevention Research	000	1	2/1/2022	NEW	$386,572
														Subtotal = $386,572

Grand Total All Awards = $1,769,263

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Access, Utilization and Outcomes of Cancer Services in the Era of Telemedicine

Award Number: R01CA267990

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/01/2022

PERIOD OF PERFORMANCE END DATE: 01/31/2027

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