PHILADELPHIA— Aiming to advance the nation’s telehealth research agenda and improve cancer-related care and outcomes, with support from the White House Cancer Moonshot, the Perelman School of Medicine at the University of Pennsylvania is one of four institutions nationally to receive a five-year, $5.7 million grant from the National Cancer Institute (NCI), part of the National Institutes of Health, for a new research center to develop and test advanced methods of telehealth delivery for cancer care with a focus on promoting health equity.
The University of Pennsylvania (Penn) Telehealth Research Center in Cancer Care (Penn TRACE), based at the Penn Center for Cancer Care Innovation (PC3I) at the Abramson Cancer Center (ACC), will become one of four NCI Telehealth Research Centers of Excellence. Being supported under the Cancer Moonshot, the grant to Penn will fund the design and testing of new telehealth strategies across the lung cancer care continuum, from screening to molecular testing to survivorship, with an emphasis on lung cancer morbidity and mortality, health disparities, and the digital divides. It will also incentivize more research on telehealth’s impact on patient outcomes, patient-provider communication, and health care use.
Three principal investigators from Penn Medicine will lead the center: Katharine Rendle, PhD, an assistant professor of Family Medicine and Community Health and deputy director at PC3I; Anil Vachani, MD, an associate professor of Pulmonary, Allergy, and Critical Care, co-director of Lung Cancer Screening at Penn Medicine, and an innovation faculty member at PC3I; and Justin Bekelman, MD, a professor of Radiation Oncology, Medicine, and Medical Ethics and Health Policy, and director of PC3I.
“For patients undergoing screening or treatment for cancer, advances in telehealth propelled by the COVID-19 pandemic could be tremendously beneficial, yet telehealth strategies must address the digital divide so as not to also exacerbate known disparities in cancer outcomes,” said Rendle. “We aim not only to ensure equal access to telehealth but also to use it in ways that reduce persistent barriers to care in order to transform how we deliver cancer care today.”
Telehealth includes video or telephone conferencing and health information exchange through secure texting or patient portals. Accelerated by clinical need and temporary waivers of reimbursement and regulatory restrictions, telehealth expanded rapidly during the pandemic. Telehealth’s potential to improve early detection and treatment of cancer is likely to be substantial, but whether and how telehealth can close gaps or inequities in cancer care delivery continues to be researched.
The core mission of Penn TRACE is to create, test and scale telehealth approaches to improve outcomes and equity in lung cancer care. Lung cancer is an urgent public health challenge which is potentially preventable through smoking cessation, yet it is the single largest type of cancer death in the United States with nearly a quarter of a million new cases of lung cancer diagnosed annually, and about 130,000 Americans who succumb to it. Lung cancer is much more treatable when caught early, and studies have shown that annual screening in higher-risk individuals, using a radiology scan called low-dose computed tomography (LDCT), can detect it early and decrease mortality. However, LDCT screening requires a consultation to review risks and benefits prior to completion, which have been challenging to implement. Thus, LDCT currently is performed for only a small fraction of the roughly 15 million Americans eligible for it.
“President Biden recently issued a call to action to the cancer community to reignite our efforts to ensure equitable access to screening, so that cancers are not diagnosed too late,” said Vachani. “Our center will be at the forefront of utilizing innovative telehealth approaches as a means to achieve that end.”
The researchers will embed rapid tests of innovative telehealth approaches linked with clinical trials across Penn’s Primary Care and Cancer Network. The center’s main trial will compare the effectiveness of telehealth strategies to increase shared decision making for lung cancer screening using an adaptive design. A second trial will test a telehealth strategy for patients with advanced lung cancer to improve timely treatment recommendations through early integration of plasma-based comprehensive molecular testing. The team’s telehealth strategies will be informed by design thinking, the discipline of innovation, communication science and behavioral economics.
“There has been a dramatic expansion in the use of telehealth in the past few years, creating a critical need to determine which telehealth methods work best, for whom, and under what conditions,” said Bekelman. “We are honored to be part of the Cancer Moonshot’s substantial investment in telehealth research, sharing Penn’s unique approach to designing and testing how telehealth can advance equitable cancer care.”
“Our commitment continues to help reduce the cancer death rate with the discovery of novel and innovative science, research, and resources, while improving the experience of patients living with and surviving cancer,” said Robert H. Vonderheide, MD, DPhil, director of the Abramson Cancer Center at Penn. “We are proud of what we are accomplishing at the Abramson Cancer Center and our mission endures to serve the community providing quality cancer care for all.”
This work will be supported by the National Cancer Institute (P50 CA271338).
Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $9.9 billion enterprise.
The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $546 million awarded in the 2021 fiscal year.
The University of Pennsylvania Health System’s patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center—which are recognized as one of the nation’s top “Honor Roll” hospitals by U.S. News & World Report—Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.
Penn Medicine is powered by a talented and dedicated workforce of more than 47,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2021, Penn Medicine provided more than $619 million to benefit our community.