Sample Research Proposal
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ENG114
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Jan 9, 2024
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Teleoncology- Bridging the Gap for Oncology Patients Student Name Department of English, Carolinas College of Health Sciences Eng. 240: Research and Evaluation Shelley Palmer, BA, MA June 29, 2020
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Introduction Cancer is the 2nd leading cause of death in the United States (CDC, 2018). Cancer does not discriminate on who it affects, how it affects the body, and how it can destroy a life. According to the Center for Disease Control and Prevention (CDC), 1.6 million people are diagnosed with cancer yearly and 600,000 people die every year (CDC, 2018). The National Cancer Institute (NCI) states that disparities occur when outcomes are improving overall but the improvements are delayed to some groups (National Cancer Institute, n.d.). The medically underserved population includes individuals with limited access to quality healthcare. Regular screening, testing, diagnosing, and treatment can be delayed to individuals that are not able to travel to specialty centers. This creates a barrier for these individuals, and teleoncology can make an impact to help alleviate some of these disparities in cancer care for the roughly 19% of the population that lives in rural areas (ACCC, 2018). Teleoncology can increase access to care for those living in remote locations, decrease costs for the healthcare system and the patient, and improve overall patient satisfaction (Doyle, 2016). The increase in the use of teleoncology does not come without complications. The most evident complication is how to correctly charge and get reimbursed for using telehealth services. Medicare and Medicaid have limited billing codes and guidelines, licensing, and prescribing vary by state for the medical professionals. Updated policies and clinical guidelines will need to be acknowledged to provide the safest care to these individuals. Teleoncology can include many aspects of care such as telephone calls, videoconferencing, virtual outreach clinics, email, even apps on a smartphone.
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According to Gilbertson-White, S., et.al. rural areas are facing a severe shortage of healthcare providers, with only one oncologist per 100,000 residents compared to five oncologists per 100,000 residents in urban and suburban areas (2019). This statistic supports the need for greater availability for individuals in rural areas. The decreased availability of oncologists can lead to a decrease in appointment availability, and an increase in the cost of traveling to larger specialty clinics for care over the entire treatment timeline. This research project will investigate teleoncology and how it can help decrease barriers for rural cancer patients. Research Methods The evidence I will gather to evaluate the use of teleoncology to decrease barriers for oncology patients will be a multi-step approach. Websites such as CDC and The National Cancer Institute (NCI)will be utilized. FastStats will be utilized which provides cancer statistics in the US. The statistics from FastStats are associated with the Centers for Disease Control and Prevention (CDC). The CDC is a national public health institute that works to protect the public on health issues and to maintain medical statistics. The National Cancer Institute (NCI) is the nation’s leader in cancer research in the US. NCI and CDC both provide cancer statistics, detailed information on types of cancer, current cancer research, and research resources. Databases such as ClinicalKey and CINAHL will be utilized to find peer-reviewed journal articles. The Oncology Nursing Society also has a database that members can use to access peer-reviewed oncology-
focused journal articles, podcasts, and books. Peer-reviewed journal articles are an important aspect of research because they give scrutiny to topics and verify that the information is factual and uphold to the standards in that area of study. Quantitative
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and qualitative articles will also be utilized to show the increasing use of telehealth in oncology patients. I utilized multiple resources to help with defining telehealth including a professional nursing textbook. Annotated Bibliography Association of Community Cancer Centers (2019). ACCC Explores Improving Cancer Care Delivery in Rural Areas, Oncology Times
, 41(22), 5. https://doi.org/10.1097/01.COT.0000615192.69774.cb This informational newspaper article describes how telemedicine is helping patients in rural areas with increased access to clinical trials and improving overall access to oncology delivery systems. It also describes how members of the Association of Community Cancer Centers are contributing to peer-driven strategies for improving the delivery of quality cancer care in rural areas. It gives an example of how an oncology-certified Nurse Practitioner based in a tertiary setting is able to provide safe care to three rural infusion clinics. The overall source is useful and gives great sources to support telemedicine for rural cancer patients. Baldwin-Medsker, A., Holland, J., & Rodriguez, E. S. (2020). Access to Care: Using eHealth to limit location-based barriers for patients with cancer.
Clinical Journal of Oncology Nursing
, 24(3), 16–
23. https://doi.org/10.1188/20.CJON.S1.16-23 This research journal article explains how ehealth can help with location barriers for patients with cancer. The location barriers can lead to delay in screening, diagnosis, and treatment. Telehealth includes conference calls, virtual visits, and the utilization of mobile devices. The article was written by master’s level nurses with oncology certification. The article encompasses barriers, ehealth interventions, as well as nursing implications. Case studies were evaluated and
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articles were utilized. This article supports my opinion that telehealth can help with barriers that rural cancer patients struggle with. Boxer, Richard J. MD,. (2017). Telemedicine: Remote Cancer Care Improves Communication. Oncology Times
, 39 (2), 1,10,16. https://doi.org/10.1097/01.COT.0000512175.80464.3f This newspaper article gives great information on ways that telehealth is going to be helpful with oncology patients. It explains what Medicare and Medicaid cover in telemedicine. It speaks to the advances that technology can bring healthcare to the patient instead of bringing the patient to healthcare. The article gives valuable information such as in 2016 there will be a potential workforce shortage of oncologists and that telemedicine or teleoncology can help with a physician shortage. Services to those distant from the specialty centers can utilize video conferencing or telephone-based health care management. Two studies were mentioned that described telephone-based education or counseling initiatives can be successful in educating individuals with familial or genetic risks to cancer. This source is very useful and positive because it offers information with great factual statistics from reliable sources. Doyle, S. (2016). Telemedicine in Oncology. Clinical Journal of Oncology Nursing
, 20(1), 27-28. https://doi.org/10.1188/16.CJON.27-28 This journal article discusses the use of telemedicine for oncology patients and how it may benefit those living in remote areas. Doyle goes into detail about how telemedicine came to be because of the differences in care for patients in rural areas compared to patients in metropolitan areas. She details how telemedicine can be beneficial in reducing healthcare costs, improving patient satisfaction, and improving overall health outcomes. The article also discusses the challenges and concerns that telemedicine brings with it; such as Medicare and Medicaid having limited availability for telemedicine billing codes, federal and state laws and regulations
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related to reimbursement for medical services and licensing is different by state. This source is useful because it supports that telemedicine can be very helpful to many patients that live far away from a specialty medical center. It adds supportive evidence and a positive perspective to telemedicine. Gilbertson-White, S., Yeung, C., Wickersham, K., (2019). “Just Living with Them”: Symptom Management Experiences of Rural Residents with Advanced Cancer. Oncology Nursing Forum
, 46(5), 531-542. https://doi.org/10.1188/19.ONF.531-542 This research journal article discusses many issues with cancer patients in rural areas. It is a research-based article that details a study on themes patients experience with advanced cancer living in rural areas. Participants in the study described barriers and challenges, management strategies, and perceptions, and the use of technology. The article also expanded on the limitations of the research study as well as the implications for nursing in rural areas. The study is informative but is also realistic in that more information from research is needed to make more definitive conclusions. Hood, L. J. (2018). Leddy & Peppers professional nursing. Philadelphia, PA: Wolters Kluwer This textbook section defines telemedicine and telehealth in a chapter regarding consumer health informatics in practice. This a nursing textbook and it explains what telemedicine is, what it includes, when the term was first used, and how it is going to become very useful in the future of healthcare. It emphasizes how telemedicine can provide specialized medical services to those without access to specialized centers. This is a good source of information because it gives a good definition for telemedicine and telehealth, which can be used interchangeably. It gives other examples of how telemedicine can be used to help patients not just in an oncology setting, but to any person in a rural area. This article gives good foundational information
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regarding telemedicine and how much technology is going to be involved in the future of nursing. National Cancer Institute. (n.d.). About Cancer. https://www.cancer.gov/about-cancer This page found on the government website provides statistics on cancer related to people living in the United States. The website is the organization known as The National Cancer Institute (NCI) which is the nation’s leader in cancer research. NCI is one of 11 groups under the National Institute of Health (NIH). NCI focuses on cancer research and training and support for cancer research. This webpage gives information on cancer statistics in many different areas. This source will give reliable information on how prevalent cancer is and to help support equal cancer care for all.
Center for Disease Control and Prevention. (2018, April 27). Cancer Statistics. https://www.cdc.gov/nchs/fastats/cancer.html This page found on the government website provides statistics on cancer related to people living in the United States. The website also called FastStats is part of the United States Cancer Statistics, (USCS) and is the official federal statistic organization. The Center for Disease Control and Prevention (CDC) is the nation’s health agency and is utilized to help educate individuals on health issues. This resource is reliable to find evidence on cancer and to use the statistics to support the research on cancer burden and trends and how telehealth can help cancer patients.