Rapid Practice Change During COVID-19 Leads to Enduring Innovations and Expansion of Integrative Oncology Services

Abstract

The COVID-19 pandemic forced cancer programs and practices to rapidly adapt how they deliver integrative oncology services that help patients manage symptoms and optimize their quality of life. Additional stressors imposed by COVID-19 increased the need for mind-body practices, natural products, and lifestyle modifications. However, literature on best practices for the provision of integrative oncology services during a pandemic is sparse. Our article seeks to describe strategies, challenges, and enduring innovations for successful integrative oncology practice during and beyond the COVID-19 crisis. Effective strategies include expanded telemedicine, online resource libraries, virtual interactive groups and classes, and additional infection prevention protocols. We also describe telemedicine challenges, such as technical difficulties and access to technology, “Zoom fatigue,” inability to perform hands-on physical exams, distractions outside the clinical environment, and obstacles to maintaining a virtual therapeutic relationship. Leveraging its skilled facilitators, Levine Cancer Institute in Charlotte, N.C., overcame many of these challenges through proactive responses, flexibility—demonstrated by staff and patients—and the use of virtual platforms. Our experience led to enduring telehealth expansion, livestream groups and classes, on-demand digital repositories of integrative practices, and targeted services delivered at the most clinically appropriate time(s). These insights may be adapted by other institutions to maintain integrative oncology services during and after unprecedented events, like a global pandemic.

Acknowledgments

The authors acknowledge William Moore for providing supporting departmental data, Dr. Declan Walsh for his review of the article, Beth York for her administrative support, and colleagues in the Department of Supportive Oncology, Levine Cancer Institute, for their feedback.

Additional information

Notes on contributors

Danielle Gentile

Danielle Gentile, PhD, is scientist, Real-World Evidence and Insights, Cardinal Health Specialty Solutions. Work completed at Levine Cancer Institute; Susan Yaguda, MSN, RN, is the manager of integrative oncology; Dean Quick, MT-BC, is a board-certified music therapist and music therapy internship director; Rebecca Greiner, PhD, PA-C, is an advanced practice provider; Shamille Hariharan, MD, MPH, is a physician; and Chasse Bailey-Dorton, MD, MSPH, is Chief, Integrative Oncology, The Department of Supportive Oncology, at Atrium Health, Levine Cancer Institute, Charlotte, N.C.

Susan Yaguda

Danielle Gentile, PhD, is scientist, Real-World Evidence and Insights, Cardinal Health Specialty Solutions. Work completed at Levine Cancer Institute; Susan Yaguda, MSN, RN, is the manager of integrative oncology; Dean Quick, MT-BC, is a board-certified music therapist and music therapy internship director; Rebecca Greiner, PhD, PA-C, is an advanced practice provider; Shamille Hariharan, MD, MPH, is a physician; and Chasse Bailey-Dorton, MD, MSPH, is Chief, Integrative Oncology, The Department of Supportive Oncology, at Atrium Health, Levine Cancer Institute, Charlotte, N.C.

Dean Quick

Danielle Gentile, PhD, is scientist, Real-World Evidence and Insights, Cardinal Health Specialty Solutions. Work completed at Levine Cancer Institute; Susan Yaguda, MSN, RN, is the manager of integrative oncology; Dean Quick, MT-BC, is a board-certified music therapist and music therapy internship director; Rebecca Greiner, PhD, PA-C, is an advanced practice provider; Shamille Hariharan, MD, MPH, is a physician; and Chasse Bailey-Dorton, MD, MSPH, is Chief, Integrative Oncology, The Department of Supportive Oncology, at Atrium Health, Levine Cancer Institute, Charlotte, N.C.

Rebecca Greiner

Danielle Gentile, PhD, is scientist, Real-World Evidence and Insights, Cardinal Health Specialty Solutions. Work completed at Levine Cancer Institute; Susan Yaguda, MSN, RN, is the manager of integrative oncology; Dean Quick, MT-BC, is a board-certified music therapist and music therapy internship director; Rebecca Greiner, PhD, PA-C, is an advanced practice provider; Shamille Hariharan, MD, MPH, is a physician; and Chasse Bailey-Dorton, MD, MSPH, is Chief, Integrative Oncology, The Department of Supportive Oncology, at Atrium Health, Levine Cancer Institute, Charlotte, N.C.

Shamille Hariharan

Danielle Gentile, PhD, is scientist, Real-World Evidence and Insights, Cardinal Health Specialty Solutions. Work completed at Levine Cancer Institute; Susan Yaguda, MSN, RN, is the manager of integrative oncology; Dean Quick, MT-BC, is a board-certified music therapist and music therapy internship director; Rebecca Greiner, PhD, PA-C, is an advanced practice provider; Shamille Hariharan, MD, MPH, is a physician; and Chasse Bailey-Dorton, MD, MSPH, is Chief, Integrative Oncology, The Department of Supportive Oncology, at Atrium Health, Levine Cancer Institute, Charlotte, N.C.

Chasse Bailey-Dorton

Danielle Gentile, PhD, is scientist, Real-World Evidence and Insights, Cardinal Health Specialty Solutions. Work completed at Levine Cancer Institute; Susan Yaguda, MSN, RN, is the manager of integrative oncology; Dean Quick, MT-BC, is a board-certified music therapist and music therapy internship director; Rebecca Greiner, PhD, PA-C, is an advanced practice provider; Shamille Hariharan, MD, MPH, is a physician; and Chasse Bailey-Dorton, MD, MSPH, is Chief, Integrative Oncology, The Department of Supportive Oncology, at Atrium Health, Levine Cancer Institute, Charlotte, N.C.