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Issued by

National Cancer Institute (NCI)

Purpose

The National Cancer Institute (NCI) is seeking information on scientific gaps and research needs related to the delivery of cancer-related care via telehealth. This request for information (RFI) is part of a planning effort designed to identify promising opportunities and set priorities for research in this area.

Background

Following the onset of the COVID-19 pandemic, there has been a dramatic increase in use of telehealth to deliver cancer-related care. This care can occur at multiple points on the cancer control continuum including but not limited to prevention, detection, diagnosis, treatment, and survivorship. As used here, telehealth refers to synchronous interactions between patients and healthcare providers using voice or voice plus video communications technology. Patient-provider interactions as used here is meant to encompass interactions of individuals who are recipients of healthcare at any point on the cancer control continuum with individuals who are healthcare providers across a broad range of disciplines. These synchronous interactions are often used in combination with in-person interactions as well as asynchronous forms of interaction (e.g., text messaging, email, and electronic collection of patient-reported outcomes).

Several factors have contributed to the recent expansion in the use of telehealth. These include attempts to limit the potential for SARS-CoV-2 infected individuals to infect others as well as limit the potential for uninfected individuals to become infected, especially those at higher risk for severe COVID-19-related illness. Changes in reimbursement and regulatory policies that previously limited the use of telehealth have also contributed to the recent upsurge.
Initial reports suggest there is support for continuing the use of telehealth to deliver several forms of cancer-related care after the current pandemic subsides. Despite these trends, telehealth remains an understudied means of delivering cancer-related care.

Information Requested

This RFI seeks information on scientific gaps that need to be addressed as cancer-related care via telehealth becomes a more common part of routine clinical practice. It also seeks information on what new resources or approaches may be needed to address these gaps. The focus is on enduring and sustainable evidence-based approaches in the use of telehealth to advance cancer prevention, detection, and control rather than short-term responses to the current pandemic.

Examples of topics related to cancer-related telehealth services for which input is sought include the following areas:

• Research gaps and opportunities for
  • addressing inequalities in access to, acceptability, and/or receipt of telehealth services;
  • using telehealth services to reduce inequalities in access to and/or receipt of cancer-related care;
  • improving empirical support for existing telehealth programs or interventions;

• • improving the patient care experience and patient-provider communications using telehealth;
  • improving patients’ knowledge and skill in using telehealth services and providers’ knowledge and skill in delivering telehealth services; and
  • using telehealth to improve health outcomes (e.g., clinical outcomes, patient-reported outcomes, and/or healthcare utilization).
• Methods and research strategies for
  • defining and evaluating the quality and value of telehealth services;
  • identifying and understanding patient and provider preferences for in-person vs. telehealth delivery of cancer-related care;
  • understanding the role of costs, insurance, and payer policies on receipt of telehealth services; and
  • conducting pragmatic and rapid cycle research on telehealth-related care delivery.
• Additional gaps in knowledge including
  • identifying emerging, and impactful research questions in cancer-related telehealth;
  • clinical infrastructure that can facilitate conducting cancer-related telehealth research;
  • key stakeholders and disciplines (scientific and clinical) to involve in telehealth research;
  • safety, ethical, security, and privacy issues in conducting research on telehealth; and
  • opportunities for incorporating policy-maker perspectives into the design of telehealth research and opportunities for disseminating findings to policy makers.

Comments on any additional issues relevant to this RFI that are not specifically mentioned above are also encouraged.

How to Submit a Response

Responses will be accepted through July 30, 2020. Please limit your response to two pages or less. Responses in electronic format are preferred and can be e-mailed to [email protected]. Please include the Notice number (NOT-CA-20-080) in the subject line. Responders are free to address any or all the categories listed above. The submitted information will be reviewed by NIH staff. Every respondent will receive an automated e-mail confirmation acknowledging receipt of a successfully submitted response but will not receive any individualized feedback.

Responses are entirely voluntary and can be anonymous. If willing, you may indicate the environment to which your perspective pertains (e.g., academia, clinical research, clinical practice). No proprietary, classified, confidential, or sensitive information should be included in your response. All individual responses will remain confidential. Any identifiers (e.g., names, institutions, e-mail addresses, etc.) will be removed when responses are compiled. Only the processed, anonymized results will be shared internally with NIH staff members and any member of scientific working groups convened by the NCI, as appropriate.

This request is for information and planning purposes only and should not be construed as a solicitation or as an obligation on the part of the Federal Government. The NIH does not intend to make any awards based on responses to this RFI or to otherwise pay for the preparation of any information submitted or for the Government's use of such information.

The NIH will use the information submitted in response to this RFI at its discretion and will not provide comments to any responder's submission. However, responses to the RFI may be reflected in future funding opportunity announcements. The information provided will be analyzed and may be aggregated in presentations and reports. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).

Inquiries

Please direct all inquiries to:

Roxanne E. Jensen, Ph.D.
National Cancer Institute (NCI)
Telephone: 240-276-7588
Email: [email protected]