D . Omid Modi amani. (2025). Tele-oncology and he Fu u e o Cance Ca e Deli e y: A Re iew o Eme ging
Models, Ru al Applica ions, and Pha maceu ical In eg a ion. MAR Oncology and Hema ology. (2025) 5:08
Tele-oncology and he Fu u e o Cance Ca e Deli e y: A Re iew o
Eme ging Models, Ru al Applica ions, and Pha maceu ical In eg a ion
D . Omid Modi amani *
*Co espondence o: D . Omid Modi amani, MD, Medical Oncologis & Hema ologis , Saudi Ge man
Hospi al, Dubai.
Copy igh .
© 2025 D . Omid Modi amani This is an open access a icle dis ibu ed unde he C ea i e Commons
A ibu ion License, which pe mi s un es ic ed use, dis ibu ion, and ep oduc ion in any medium, p o ided
he o iginal wo k is p ope ly ci ed.
Recei ed: 21 Aug 2025
Published: 28 Aug 2025
MAR Oncology and Hema ology (2025) 5:08
Re iew A icle
D . Omid Modi amani, MAR Oncology and Hema ology (2025) 5:08.
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D . Omid Modi amani. (2025). Tele-oncology and he Fu u e o Cance Ca e Deli e y: A Re iew o Eme ging
Models, Ru al Applica ions, and Pha maceu ical In eg a ion. MAR Oncology and Hema ology. (2025) 5:08
Abs ac
Impo ance: Teleoncology— he use o elemedicine echnologies in oncology—has eme ged as
a c i ical ool in add essing cance ca e dispa i ies, pa icula ly among u al, unde se ed,
and esou ce-limi ed popula ions. Despi e g owing adop ion, comp ehensi e syn hesis o i s
implemen a ion, ba ie s, and u u e di ec ions emains limi ed.
Objec i e: To e iew he his o ical e olu ion, co e applica ions, challenges, and u u e
di ec ions o eleoncology, wi h emphasis on u al deploymen , pha maceu ical indus y
in eg a ion, and implica ions o equi y-based cance ca e deli e y.
E idence Re iew: A na a i e e iew was conduc ed o li e a u e published be ween Janua y
2005 and Ma ch 2024 using PubMed, Scopus, WHO epo s, ASCO esou ces, and policy
documen s om oncology o ganiza ions and go e nmen heal h agencies. Included sou ces
comp ised pee - e iewed s udies, whi e pape s, p og am e alua ions, and egula o y
amewo ks. Key hemes we e syn hesized unde domains including access o ca e, emo e
ea men moni o ing, decen alized ials, pa ien expe ience, in as uc u e, and s akeholde
collabo a ion.
Findings: Teleoncology has e ol ed om ea ly second-opinion consul s o comp ehensi e
models including emo e diagnosis, i ual umo boa ds, emo e chemo he apy supe ision,
and digi al na iga ion ools. Ru al implemen a ion in he Uni ed S a es has shown signi ican
bene i s including educed a el bu den, imp o ed ime- o- ea men , and non-in e io
su i al a es. Globally, coun ies such as Aus alia, India, and Kenya ha e adop ed
eleoncology o ex end se ices o emo e a eas. Majo pha maceu ical companies now suppo
eleoncology-enabled decen alized clinical ials, AI-powe ed symp om acking, and eal-
wo ld e idence gene a ion. Key ba ie s o implemen a ion include in as uc u e de ici s,
inconsis en eimbu semen , egula o y misalignmen , digi al li e acy gaps, and e hical
conce ns abou da a use. Eme ging hyb id ca e models, equi y-cen e ed pla o m design, and
global licensing amewo ks a e shaping he u u e landscape.
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D . Omid Modi amani. (2025). Tele-oncology and he Fu u e o Cance Ca e Deli e y: A Re iew o Eme ging
Models, Ru al Applica ions, and Pha maceu ical In eg a ion. MAR Oncology and Hema ology. (2025) 5:08
Implica ions o P ac ice and Policy
The expansion o eleoncology has p o ound implica ions o he u u e o cance ca e deli e y, pa icula ly
in add essing geog aphic and socioeconomic dispa i ies. Fo clinical p ac ice, i enables oncologis s o ex end
hei each in o u al and unde se ed communi ies, imp o ing imely access o diagnosis, ea men , and
su i o ship se ices. Adop ion o i ual umo boa ds, emo e moni o ing ools, and hyb id models allows
o con inui y o ca e wi hou comp omising clinical ou comes—especially o pa ien s wi h anspo a ion,
mobili y, o immunosupp ession challenges.
Fo policymake s, eleoncology highligh s he u gen need o s anda dized eimbu semen , c oss-s a e
licensu e e o ms, and in es men in digi al in as uc u e, pa icula ly b oadband in u al a eas. Equi able
access also equi es a en ion o digi al li e acy p og ams, language se ices, and cul u ally ailo ed pla o ms.
Regula o s and paye s should suppo he in eg a ion o eleoncology in o alue-based oncology paymen
models and na ional cance con ol plans, ensu ing sus ainabili y beyond pilo ini ia i es.
S a egic alignmen be ween heal hca e sys ems, go e nmen agencies, and he pha maceu ical indus y is
essen ial o scale eleoncology e hically and e ec i ely. I s success will depend no jus on echnology, bu on
policies ha p io i ize equi y, in e ope abili y, and long- e m heal h sys em esilience.
In oduc ion
Cance ca e deli e y has adi ionally elied on cen alized e ia y o academic medical cen e s, esul ing in
signi ican geog aphic and socioeconomic dispa i ies in access o oncologic se ices. In he Uni ed S a es
alone, nea ly 20% o he popula ion esides in u al a eas, ye ewe han 5% o oncologis s p ac ice in hose
egions [1]. This maldis ibu ion o he oncology wo k o ce has led o documen ed delays in diagnosis, limi ed
pa icipa ion in clinical ials, and wo se su i al ou comes o u al and unde se ed popula ions [2,3].
Conclusions and Rele ance: Teleoncology is ede ining cance ca e by enabling mo e equi able,
scalable, and digi ally in eg a ed deli e y models. As heal hca e sys ems ansi ion o hyb id oncology
ecosys ems, success will depend on coo dina ed policy e o m, sus ained in as uc u e in es men ,
and c oss-sec o pa ne ships—including pha maceu ical and echnology s akeholde s. Fu u e models
mus ensu e cul u al esponsi eness, digi al inclusion, and long- e m sus ainabili y o ul ill he
p omise o eleoncology in imp o ing global cance ou comes.
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D . Omid Modi amani. (2025). Tele-oncology and he Fu u e o Cance Ca e Deli e y: A Re iew o Eme ging
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Teleoncology—a subse o elemedicine speci ically applied o cance diagnosis, ea men planning, symp om
managemen , and ollow-up—has eme ged as a scalable, echnology-enabled s a egy o add ess hese
inequi ies. I le e ages digi al communica ion ools o connec pa ien s wi h emo e oncologis s, enable i ual
umo boa ds, moni o chemo he apy oxici y, and conduc decen alized clinical ials [4].
The ield o eleoncology e ol ed om ea ly expe imen s in emo e umo boa d pa icipa ion and second-
opinion consul a ions in he ea ly 2000s o comp ehensi e i ual cance ca e ecosys ems. These include
secu e eleheal h pla o ms in eg a ed wi h elec onic heal h eco ds (EHRs), a i icial in elligence (AI)–
enabled iage sys ems, and digi al pa hology se ices [5,6]. The COVID-19 pandemic accele a ed he
adop ion o elemedicine in oncology, p omp ing empo a y egula o y wai e s, expanded eimbu semen
om public and p i a e paye s, and apid scaling o in as uc u e [7].
As eleoncology becomes embedded in ou ine p ac ice, i se es as a c i ical modali y o eaching pa ien s
in u al U.S. coun ies (65% o which lack a ull- ime oncologis ) and in low- esou ce se ings globally [8,9].
Mo eo e , i enables inclusi e ca e models o popula ions ha his o ically ha e had poo ep esen a ion in
clinical ials, such as acial and e hnic mino i ies, he elde ly, and geog aphically isola ed g oups [10].
This e iew explo es he e olu ion o eleoncology, i s co e applica ions ac oss he cance ca e con inuum,
egional implemen a ion e o s, he ole o pha maceu ical indus y s akeholde s, and u u e di ec ions in
ensu ing equi able, inno a i e cance ca e deli e y.
His o ical De elopmen o Teleoncology
The ounda ion o eleoncology da es back o gene al elemedicine inno a ions in he la e 1990s and ea ly
2000s. Ini ially, elemedicine was adop ed o u gen ca e and specialis consul a ion in emo e a eas by
go e nmen agencies such as NASA and he Depa men o De ense. Oncology-speci ic applica ions eme ged
as cance cen e s sough o each medically unde se ed popula ions in u al and on ie egions [11,12].
Ea ly Phase (2000–2010):
In his pe iod, eleoncology p ima ily in ol ed:
• Second-opinion consul a ions ia ideocon e encing be ween e ia y cen e s and u al clinics.
• Vi ual umo boa ds, allowing collabo a i e e iew o pa ien cases ac oss ins i u ions.
• Telepa hology, enabling digi al ansmission o his ology slides o emo e diagnos ic inpu .
P og ams such as he Queensland Teleoncology P og am in Aus alia pionee ed his model o deli e cance
se ices o Indigenous communi ies [13]. In he U.S., academic hospi als began pa ne ing wi h Ve e ans
A ai s (VA) and c i ical access hospi als o ex end se ices [14].
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D . Omid Modi amani. (2025). Tele-oncology and he Fu u e o Cance Ca e Deli e y: A Re iew o Eme ging
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G ow h Phase (2011–2019):
This e a saw enhanced up ake due o:
• B oadband expansion and ede al g an s, especially in he U.S. h ough FCC’s Ru al Heal h Ca e P og am.
• Widesp ead adop ion o elec onic heal h eco ds (EHRs), enabling emo e access o labs, imaging, and
ea men plans [15].
• S uc u ed clinical wo k lows, including local nu ses o gene al physicians acili a ing ideo consul s wi h
o si e oncologis s.
• Pilo p og ams, such as hose in Alaska, A izona, and Minneso a, which showed imp o emen s in imely
ca e and pa ien sa is ac ion [16].
S udies om his pe iod demons a ed ha eleoncology was non-in e io o in-pe son isi s o ea men
decisions, symp om managemen , and ollow-up ca e, pa icula ly when suppo ed by well- ained local eams
[17].
COVID-19 Ca alysis (2020–2022):
The COVID-19 pandemic ac ed as a sys emic accele an :
• CMS and o he paye s implemen ed empo a y wai e s allowing c oss-s a e licensu e and eimbu sed ele-
oncology se ices a pa i y wi h in-pe son ca e [18].
• Rapid digi al in as uc u e deploymen occu ed ac oss academic and p i a e cance cen e s.
• Vi ual chemo he apy supe ision p o ocols we e de eloped, combining elemedicine isi s wi h emo e
oxici y moni o ing and eme gency iage pa hways.
• Pa ien accep ance su ged, wi h up o 87% o pa ien s exp essing sa is ac ion wi h i ual cance isi s o
ollow-up, symp om checks, and su i o ship ca e [19, 20].
Consolida ion and Inno a ion (2023–P esen ):
Recen yea s ha e seen ma u a ion o eleoncology in as uc u e and mo e sophis ica ed applica ions:
• In eg a ion o a i icial in elligence (AI) in emo e moni o ing, p edic i e analy ics, and digi al na iga ion
ools [21].
• Pha maceu ical pa ne ships wi h oncology cen e s o deli e decen alized clinical ials using e-consen ,
home isi s, and cou ie -based d ug deli e y sys ems [22].
• Global adap a ions, especially in low- and middle-income coun ies (LMICs), whe e eleoncology is being
used o suppo sc eening, iage, and ollow-up o b eas , ce ical, and p os a e cance [23].
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Eme ging inno a ions also include hyb id models combining asynch onous consul a ions, wea able de ices,
and eal- ime ale s o ea ly de ec ion o complica ions. These ools a e being pilo ed in u al U.S. s a es and
LMICs, signaling a mo e inclusi e and sus ainable oncology u u e [24].
Co e Applica ions o Teleoncology
Teleoncology encompasses a b oad spec um o se ices beyond ideo consul a ions. I s applica ions a e now
embedded ac oss a ious s ages o cance ca e, including sc eening, diagnos ics, ea men moni o ing, clinical
ial pa icipa ion, pallia i e suppo , and su i o ship. These modali ies a e no only use ul in u al a eas bu
also in u ban unde se ed communi ies, pos -disas e zones, co ec ional acili ies, and low- and middle-
income coun ies (LMICs) [25].
1. Remo e Consul a ions
Remo e ideo consul a ions allow pa ien s o engage wi h oncologis s o diagnosis, ea men planning, and
ollow-up wi hou he need o a el o special y cen e s. These consul a ions a e ypically conduc ed using
HIPAA-complian eleheal h pla o ms in eg a ed wi h elec onic heal h eco ds (EHRs) [26].
Key bene i s:
Dec eased pa ien a el cos s and absen eeism om wo k [27]
Sho e wai imes o ini ial e alua ion [28]
G ea e access o sub-specialis s, including medical oncologis s, adia ion oncologis s, and gene ic
counselo s
Imp o ed coo dina ion be ween u al p ima y ca e physicians and academic cen e s [29]
A s udy om he U.S. Ve e ans Heal h Adminis a ion demons a ed ha ele-oncology educed ime o
chemo he apy ini ia ion by 26% in u al e e ans wi h newly diagnosed cance [30].
2. Vi ual Tumo Boa ds
Mul idisciplina y umo boa ds (MTBs) a e essen ial in de eloping consensus-based ea men plans. Vi ual
MTBs enable pa icipa ion by specialis s ac oss di e en ins i u ions—especially help ul when expe ise in
adia ion oncology, pa hology, o su gical oncology is no locally a ailable [31].
Func ionali y includes:
Collabo a i e e iew o imaging, his opa hology, and genomics
Sha ed decision-making wi h eal- ime inpu om e ia y and local p o ide s
Abili y o include he pa ien o hei local p o ide in he discussion [32]
E idence shows ha i ual MTBs educe unnecessa y ans e s o e ia y cen e s and inc ease clinical ial
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en ollmen a es by connec ing pa ien s wi h dis an ial si es [33].
3. Remo e Chemo he apy Moni o ing and Symp om Managemen
Teleoncology suppo s sa e chemo he apy adminis a ion in local acili ies unde i ual supe ision. This
model is especially e ec i e in u al a eas, whe e ained nu sing s a adminis e he apy while oncologis s
moni o side e ec s, manage oxici ies, and adjus ea men plans emo ely [34].
Technologies used:
ePRO (elec onic pa ien - epo ed ou comes) pla o ms
AI-assis ed symp om iage sys ems
Video check-ins be o e each chemo he apy cycle
Wea ables o ack empe a u e, blood p essu e, oxygen sa u a ion, and a igue pa e ns [35]
One p og am in u al Canada educed eme gency oom isi s ela ed o chemo he apy oxici y by 37% using
elemoni o ing ools [36].
4. Decen alized Clinical T ials (DCTs)
Teleoncology is e olu ionizing ial pa icipa ion by emo ing geog aphic ba ie s. Pha maceu ical
companies and academic cen e s now le e age eleheal h pla o ms o en oll pa ien s emo ely, deli e
in es iga ional d ugs o homes, and collec da a i ually [37].
Fea u es o ele-enabled DCTs:
eConsen and emo e eligibili y sc eening
Cou ie -based biosample collec ion
In eg a ion o wea able de ice da a and emo e lab moni o ing
Real- ime ad e se e en epo ing
The FDA epo ed a 42% inc ease in decen alized ial p o ocols in oncology since 2021, wi h highe
en ollmen o u al and mino i y pa ien s compa ed o con en ional designs [38].
5. Psychosocial Suppo and Pallia i e Ca e
Teleoncology allows o he in eg a ion o men al heal h se ices, spi i ual ca e, and pallia i e symp om
managemen in bo h ea ly-s age and e minal cance ca e [39].
Applica ions:
Vi ual counseling o dep ession, anxie y, and PTSD
Remo e symp om managemen (e.g., pain, nausea, cons ipa ion, b ea hlessness)
Vi ual amily mee ings and end-o -li e planning
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Be ea emen suppo o ca egi e s
S udies show ha i ual pallia i e ca e in e en ions esul in highe pa ien sa is ac ion and educed hospi al
eadmissions in he inal 30 days o li e [40,41].
Ru al Implemen a ion in he Uni ed S a es
The u al cance ca e c isis in he U.S. is one o he mos p essing equi y issues in oncology. App oxima ely
60 million Ame icans li e in u al a eas, ye 65% o U.S. u al coun ies ha e no p ac icing oncologis , and
o e 35% lack any ype o subspecialis ca e [42,43]. These geog aphic dispa i ies con ibu e o la e -s age
diagnoses, lowe pa icipa ion in clinical ials, and highe cance - ela ed mo ali y [44].
Teleoncology p o ides a p ac ical solu ion o hese access gaps by enabling i ual oncology se ices, sha ed
ca e models, and local chemo he apy adminis a ion unde emo e supe ision. Se e al ede al and s a e-led
p og ams ha e pilo ed and scaled eleoncology in e en ions o suppo u al popula ions, especially in
Appalachia, he Midwes , and Na i e Ame ican ibal e i o ies [45].
1. Key Ou comes Demons a ed in Ru al Teleoncology Models
Mul iple s udies and pilo p og ams ha e con i med angible bene i s o eleoncology in u al communi ies:
Imp o ed Time- o-T ea men : Pa ien s ecei ing ini ial consul a ion ia eleoncology had a 25–30%
educ ion in ime om diagnosis o ea men ini ia ion compa ed o hose e e ed o in-pe son
oncology [46].
Reduced T a el Bu den: Pa ien s sa ed an a e age o 120–200 miles o a el pe oncology isi ,
signi ican ly educing absen eeism, cos , and ca egi e s ain [47].
Imp o ed T ea men Adhe ence: S udies in Mon ana and Kansas showed ha emo e ollow-up ia
eleoncology led o highe chemo he apy comple ion a es compa ed o pa ien s wi hou ongoing
specialis access [48].
Su i al Ou comes: A 2022 compa a i e analysis ac oss six s a es ound ha u al cance pa ien s
engaged in s uc u ed eleoncology p og ams had non-in e io 2-yea su i al a es compa ed o
ma ched u ban coho s [49].
2. Regional Teleoncology P og ams and Inno a ions
Se e al p ominen p og ams highligh how eleoncology has been implemen ed a scale:
Ve e ans A ai s (VA) Na ional TeleOncology P og am: Deployed ac oss 33 u al VA si es, his model
combines emo e oncologis s a ing, nu se na iga ion, and EHR-in eg a ed eleheal h. VA epo s
show o e 12,000 i ual oncology isi s we e conduc ed in 2022 alone [50].
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A izona Telemedicine P og am (ATP): Le e aging academic- u al pa ne ships, ATP connec s majo
cance cen e s wi h ibal heal h clinics in Na ajo Na ion, imp o ing cul u ally sensi i e cance
educa ion and ollow-up [51].
Neb aska Vi ual Oncology Clinics: Hyb id models u ilize in-pe son oncology nu ses and mid-le el
p o ide s a u al sa elli e clinics wi h emo e oncologis supe ision. This s uc u e enabled
chemo he apy in usion a 22 u al hospi als, wi h ze o g ade ≥3 ad e se e en s epo ed unde emo e
guidance [52].
3. Ru al Pa ien Expe ience and Sa is ac ion
Beyond clinical me ics, u al pa ien s epo high sa is ac ion wi h eleoncology when se ices a e designed
wi h empa hy, con inui y, and cul u al awa eness:
Pa ien Sa is ac ion Ra es exceed 90% in s uc u ed eleoncology p og ams, especially when pa ien s
can ecei e ca e a local acili ies wi h known p o ide s [53].
T us Building: Teleoncology pla o ms ha include local nu ses o p ima y ca e p o ide s du ing
emo e isi s os e us and cul u al compa ibili y, especially among Na i e Ame ican and Hispanic
communi ies [54].
Digi al Di ide Conside a ions: Success ul u al eleoncology p og ams p o ide digi al na iga ion
suppo , low-bandwid h pla o m op ions, and language ansla ion se ices o accommoda e olde
adul s, pa ien s wi h limi ed li e acy, o non-English speake s [55].
4. Challenges Unique o Ru al Se ings
While eleoncology has demons a ed s ong ou comes, se e al pe sis en ba ie s emain in u al a eas:
Ca ego y
Challenge Desc ip ion
Technological.
Limi ed b oadband in some on ie egions; ou da ed ha dwa e [56]
Clinical Suppo
Sho age o ained in usion nu ses and on-si e diagnos ic ools
Reimbu semen
Inconsis en paye policies and lack o co e age o nu se co- isi s
In as uc u e
Small hospi als o en lack p i a e ooms o bandwid h o secu e sessions
Cul u al Ba ie s
Mis us o emo e ca e models, especially among olde o Indigenous pa ien s
Add essing hese equi es policy coo dina ion, s akeholde engagemen , and equi y-cen e ed design in
pla o m de elopmen and se ice deli e y [57].
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medica ion adhe ence, appoin men eminde s, and access o i ual nu se cha bo s.
Tools include:
o AI-d i en symp om checke s ha p o ide eal- ime iage ecommenda ions and escala e
c i ical cases o oncologis s
o Mobile apps o o al chemo he apy adhe ence, de eloped in pa ne ship wi h academic cen e s
o In e ac i e educa ional con en , pa icula ly in oncology indica ions wi h high pa ien bu den
like b eas , lung, and colo ec al cance [108]
A No a is-led pilo showed ha pa ien s using hei oncology digi al suppo app had a 17% imp o emen in
medica ion adhe ence and a 25% educ ion in ER isi s compa ed o s anda d ca e [109].
4. Real-Wo ld Da a (RWD) and E idence (RWE) Gene a ion
Teleoncology c ea es no el pa hways o eal-wo ld da a (RWD) collec ion h ough wea able in eg a ion,
home-based diagnos ics, and digi al ques ionnai es—allowing pha ma o ack d ug e ec i eness and oxici y
in e e yday se ings.
Bene i s o pha ma include:
o Pos -ma ke ing su eillance ia emo e symp om acking and wea able da a
o Inclusion o unde ep esen ed popula ions (e.g., u al, mino i y) in obse a ional s udies
o Adap i e ial models, using RWE o in o m p o ocol e inemen s in eal ime [110]
Companies a e inc easingly in eg a ing ele-oncology da ase s wi h eal-wo ld e idence pla o ms such
as Fla i on Heal h (acqui ed by Roche), Ve ily (Google), and Tempus [111].
Roche’s in eg a ed RWE p og am using eleoncology ools en olled o e 22,000 cance pa ien s om non-
u ban a eas be ween 2021 and 2023, gene a ing ac ionable da a on esponse and ole abili y ends [112].
5. E hical and Comme cial Conside a ions
While he in eg a ion o pha ma in eleoncology is p omising, i also aises ques ions ega ding da a
owne ship, con lic o in e es , and digi al equi y:
Conce ns:
o Risk o p e e en ial digi al ools o pa ien s on company-sponso ed d ugs
o Consen cla i y when digi al ools collec clinical ial o biome ic da a
o Access dispa i ies i ools a e ied o speci ic geog aphies o insu ance plans
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Guidelines om he In e na ional Socie y o Pha macoepidemiology (ISPE) and T ansCele a e BioPha ma
emphasize e hical in eg a ion o digi al ools wi h anspa ency and pa ien con ol o da a sha ing [113].
Fu u e Di ec ions in Teleoncology
The u u e o eleoncology lies a he in e sec ion o echnological ad ancemen , policy e o m, equi y-
cen e ed design, and in e disciplina y collabo a ion. As cance ca e becomes inc easingly decen alized and
digi ally enabled, eleoncology is posi ioned no only o expand access bu also o ede ine he quali y,
e iciency, and inclusi i y o oncology se ices wo ldwide.
1. AI-Enabled Remo e Moni o ing and P edic i e Analy ics
A i icial in elligence (AI) is apidly ans o ming emo e ca e by enabling:
Ea ly de ec ion o oxici y o de e io a ion h ough p edic i e models ained on emo e moni o ing
da a
Na u al language p ocessing (NLP) o iage pa ien messages and e-symp om epo s
Compu e ision o assess ashes, wounds, o mo emen diso de s ia sma phone came as [114]
Wea ables (e.g., sma wa ches, biosenso s) in eg a ed wi h oncology pla o ms can ack:
Vi al signs (HR, BP, O₂ sa u a ion)
Sleep and ac i i y le els
Chemo he apy-induced neu opa hy o a igue pa e ns
A mul icen e s udy using AI-linked emo e moni o ing ound 30% ea lie de ec ion o g ade 2+ oxici ies and
a 42% educ ion in unplanned hospi aliza ions [115].
2. Equi y-Cen e ed and Inclusi e Design
Ensu ing ha eleoncology add esses dispa i ies— a he han ampli ying hem— equi es:
Language access ools, including eal- ime in e p e e s and mul ilingual apps
Digi al na iga o s o suppo olde adul s, low-li e acy use s, and pe sons wi h disabili ies
Asynch onous op ions (s o e-and- o wa d) o low-bandwid h o digi ally unde se ed communi ies
[116]
Communi y pa ne ships, cul u ally ailo ed con en , and locally co-designed solu ions a e essen ial o ensu e
eleoncology is no a “one-size- i s-all” app oach.
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The Digi al Equi y Oncology F amewo k by ASCO ecommends equi y audi s, u al b oadband in es men ,
and demog aphic da a acking o ensu e inclusion in i ual ca e models [117].
3. S anda dized Global Policy F amewo ks
To ha monize he eleoncology landscape ac oss egions and s akeholde s, u u e e o s mus p io i ize:
Uni ied licensu e models (e.g., In e s a e Medical Licensu e Compac in he U.S., egional ecogni ion
in EU/GCC)
Reimbu semen pa i y laws o eleheal h ac oss p i a e and public paye s
C oss-bo de da a-sha ing ag eemen s o enable secu e, in e ope able oncology eco ds [118]
WHO and ITU a e de eloping a global policy amewo k o elemedicine, and he In e na ional Agency o
Resea ch on Cance (IARC) ad oca es o eleoncology in eg a ion in na ional cance con ol plans by 2030
[119].
4. Hyb id Models o Cance Ca e Deli e y
The u u e model is nei he ully i ual no ully in-pe son, bu a hyb id app oach op imized o e iciency,
pe sonaliza ion, and sa e y:
Ini ial diagnos ic and s aging e alua ions pe o med in pe son
T ea men planning and ollow-up conduc ed i ually when app op ia e
Home chemo he apy p og ams wi h emo e supe ision and nu se isi s
Mobile heal h ans o u al hubs se ing as physical poin s o con ac [120]
S udies ha e shown ha hyb id ca e models can main ain clinical ou comes equi alen o adi ional ca e,
while imp o ing con enience and pa ien sa is ac ion by 35%–45% [121].
5. In e disciplina y Ecosys ems and Oncology Lea ning Ne wo ks
Fu u e eleoncology success equi es seamless collabo a ion be ween:
Clinicians, pha macis s, IT eams, and pa ien na iga o s
Academia, pha ma, public heal h, and ech sec o s
C oss-sec o lea ning collabo a i es (e.g., P ojec ECHO Oncology, ASCO’s Teleoncology Resou ce
Cen e )
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Cloud-based oncology lea ning ne wo ks will os e :
Vi ual con inuing medical educa ion (CME)
Mul isi e umo boa ds and pee consul a ion
Open-sou ce da ase s o AI de elopmen in oncology ca e [122]
6. Pe sonalized Digi al Oncology and Value-Based In eg a ion
Teleoncology will e ol e om being a ool o access o a p ecision ca e pla o m, inco po a ing:
Genomic da a and molecula p o iling in o emo e consul s
Value-based oncology bundles eimbu sed ac oss hyb id deli e y
Pe sonalized ea men plans upda ed ia pa ien - epo ed ou comes (PROs) and wea able me ics
O ganiza ions like Fla i on Heal h and Tempus a e combining genomic-EHR- eleoncology da a ecosys ems,
enabling eal- ime pe sonalized cance ca e emo ely [123].
Conclusions
Teleoncology s ands a he o e on o eimagining cance ca e—shi ing i om agmen ed, geog aphically
bound se ices o an in e connec ed, equi able, and digi ally op imized ecosys em. The in eg a ion o AI ools,
wea able moni o ing, and hyb id ca e models holds he p omise o enhancing pa ien sa e y, adhe ence, and
clinical ou comes. Global adop ion, howe e , will depend on sus ained in es men in digi al in as uc u e,
egula o y ha moniza ion, equi able eimbu semen models, and e hical pa ne ships ac oss s akeholde s
including go e nmen s, academic ins i u ions, echnology companies, and he pha maceu ical indus y.
Teleoncology is no longe an eme gency wo ka ound bu an endu ing pilla in he global cance ca e
con inuum.
Con lic o In e es Disclosu es
D . Omid Modi amani epo s no con lic s o in e es ele an o he con en o his a icle. The au ho has no
a ilia ions wi h o inancial in ol emen in any o ganiza ion o en i y wi h a di ec inancial in e es in he
subjec ma e discussed in his manusc ip .
Funding/Suppo
This e iew ecei ed no ex e nal unding o g an suppo . The wo k was conduc ed as pa o he au ho ’s
academic and p o essional commi men o inno a ion and equi y in cance ca e deli e y.
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Role o he Funde /Sponso
No applicable.
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