Feature

Telemedicine support group offers convenience, community to young adults with cancer

Laura Melton, PhD, ABPP
Laura Melton

A cancer diagnosis in young adulthood can be challenging not only in the complicated emotions it engenders, but also in the logistical obstacles it presents for patients in the prime of their lives.

“We know that our younger patients are often still working; many of them have young families,” Laura Melton, PhD, ABPP, medical director for supportive oncology at University of Colorado Cancer Center at University of Colorado Hospital, said in an interview with Healio. “They’ve got not only their own schedules to think about, but also children to consider. This is also a group of people who are somewhat marginalized by the fact that there are fewer people in that demographic who get cancer.”

Recognizing the unmet need for emotional support among this patient population, Melton and colleagues introduced a telemedicine psychotherapy support group specifically for young patients with cancer.

“This was a 6-week pilot program, done entirely over video conferencing. People lived across the state of Colorado,” Melton told Healio. “At some point, they decided they wanted to have each other’s contact information. They exchanged phone numbers and email addresses, and some of them got together in person after the group ended. They really developed a bond.”

Melton spoke with Healio about the pilot program, which won an Association of Community Cancer Centers (ACCC) Innovator Award, and discussed how telemedicine can be leveraged in the future for patients with cancer of all ages.

Question: Did patients participate in the program from their homes?

Answer: For this pilot program, patients were in the comfort of their homes. We received grant funding for this program, so we were able to send them a tablet preloaded with Zoom, a teleconferencing platform. We sent them a headset, as well, so that they had some privacy.

Q: Was this covered by insurance?

A: No. We wanted to start with something that had fewer barriers to entry rather than billable services. Support groups typically are not billed for.

Q : What topics did the group discuss?

A: We talked about challenges these patients faced in terms of dealing with cancer and its treatment in your 20s or 30s. What do you tell your boss about your cancer when you’re trying to work your way up in your profession? How do you handle dating? When do you tell someone you’re dating that you have cancer? Do you tell them? How much is OK to hide? What should you make sure you don’t hide? Basically, it was a lot of issues that other patients in that age range can understand and provide support around. Even if the issues aren’t exactly the same, these are similar people who get it.

Q: Can you discuss the ACCC Innovator Award?

A: The ACCC Innovator Award recognizes ways we can innovate in the field of oncology. We know that our society connects electronically in a way with which health care has not kept up. When you think about the demographic of young adults aged 18 to 40 years in the United States, those folks have an especially high use of social media and technology, and they are very used to connecting with people electronically. It was wonderful to receive this award and be recognized for the work we’re doing here in Colorado. We have a very interesting state, with very few large metropolitan areas and a lot of rural areas. People in these small mountain towns have to deal with roads closed due to snowstorms, avalanches, mudslides, animals in the road. It’s a different kind of struggle for our rural folks than for those in other areas. This is a great opportunity to test the feasibility of telemedicine.

After this pilot project ended, we went on to offer a lot of different opportunities for our patients to connect electronically. Sadly, the young adult group currently is not being offered via video conferencing for a number of reasons, but we offer several other groups, either electronically or as hybrid models where people can come in person with an option for video or telephone call-in.

Q: What are some priorities of your telemedicine research going forward?

A: The insurance billing component is a big complicating factor. You have to consider the infrastructure that needs to exist for people to have access in their homes to the correct technologies. Then there are licensure issues. As a psychologist, I’m licensed in the state of Colorado, and therefore the people I serve must be in Colorado at the time they are receiving services. That’s why we had to limit the pilot project to people in Colorado, so we knew that we were within our jurisdiction. However, we are a large cancer center that sees people from many different states. We’re working on creating interstate resources for our professionals. We want them to be able to practice telemedicine and reach the people we need to reach, wherever they’re located. – by Jennifer Byrne

For more information:

Laura Melton, PhD, ABPP, can be reached at MS 8117, 12801 E. 17th Ave., Aurora, CO 80045; email: laura.melton@cuanschutz.edu.

Disclosures: Melton reports no relevant financial disclosures.

Laura Melton, PhD, ABPP
Laura Melton

A cancer diagnosis in young adulthood can be challenging not only in the complicated emotions it engenders, but also in the logistical obstacles it presents for patients in the prime of their lives.

“We know that our younger patients are often still working; many of them have young families,” Laura Melton, PhD, ABPP, medical director for supportive oncology at University of Colorado Cancer Center at University of Colorado Hospital, said in an interview with Healio. “They’ve got not only their own schedules to think about, but also children to consider. This is also a group of people who are somewhat marginalized by the fact that there are fewer people in that demographic who get cancer.”

Recognizing the unmet need for emotional support among this patient population, Melton and colleagues introduced a telemedicine psychotherapy support group specifically for young patients with cancer.

“This was a 6-week pilot program, done entirely over video conferencing. People lived across the state of Colorado,” Melton told Healio. “At some point, they decided they wanted to have each other’s contact information. They exchanged phone numbers and email addresses, and some of them got together in person after the group ended. They really developed a bond.”

Melton spoke with Healio about the pilot program, which won an Association of Community Cancer Centers (ACCC) Innovator Award, and discussed how telemedicine can be leveraged in the future for patients with cancer of all ages.

Question: Did patients participate in the program from their homes?

Answer: For this pilot program, patients were in the comfort of their homes. We received grant funding for this program, so we were able to send them a tablet preloaded with Zoom, a teleconferencing platform. We sent them a headset, as well, so that they had some privacy.

Q: Was this covered by insurance?

A: No. We wanted to start with something that had fewer barriers to entry rather than billable services. Support groups typically are not billed for.

Q : What topics did the group discuss?

A: We talked about challenges these patients faced in terms of dealing with cancer and its treatment in your 20s or 30s. What do you tell your boss about your cancer when you’re trying to work your way up in your profession? How do you handle dating? When do you tell someone you’re dating that you have cancer? Do you tell them? How much is OK to hide? What should you make sure you don’t hide? Basically, it was a lot of issues that other patients in that age range can understand and provide support around. Even if the issues aren’t exactly the same, these are similar people who get it.

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Q: Can you discuss the ACCC Innovator Award?

A: The ACCC Innovator Award recognizes ways we can innovate in the field of oncology. We know that our society connects electronically in a way with which health care has not kept up. When you think about the demographic of young adults aged 18 to 40 years in the United States, those folks have an especially high use of social media and technology, and they are very used to connecting with people electronically. It was wonderful to receive this award and be recognized for the work we’re doing here in Colorado. We have a very interesting state, with very few large metropolitan areas and a lot of rural areas. People in these small mountain towns have to deal with roads closed due to snowstorms, avalanches, mudslides, animals in the road. It’s a different kind of struggle for our rural folks than for those in other areas. This is a great opportunity to test the feasibility of telemedicine.

After this pilot project ended, we went on to offer a lot of different opportunities for our patients to connect electronically. Sadly, the young adult group currently is not being offered via video conferencing for a number of reasons, but we offer several other groups, either electronically or as hybrid models where people can come in person with an option for video or telephone call-in.

Q: What are some priorities of your telemedicine research going forward?

A: The insurance billing component is a big complicating factor. You have to consider the infrastructure that needs to exist for people to have access in their homes to the correct technologies. Then there are licensure issues. As a psychologist, I’m licensed in the state of Colorado, and therefore the people I serve must be in Colorado at the time they are receiving services. That’s why we had to limit the pilot project to people in Colorado, so we knew that we were within our jurisdiction. However, we are a large cancer center that sees people from many different states. We’re working on creating interstate resources for our professionals. We want them to be able to practice telemedicine and reach the people we need to reach, wherever they’re located. – by Jennifer Byrne

For more information:

Laura Melton, PhD, ABPP, can be reached at MS 8117, 12801 E. 17th Ave., Aurora, CO 80045; email: laura.melton@cuanschutz.edu.

Disclosures: Melton reports no relevant financial disclosures.