publication date: May. 22, 2020
A telesitevisit: Cancer center site visits go virtual amid COVID-19 pandemic
By Matthew Bin Han Ong
This story is part of The Cancer Letter’s ongoing coverage of COVID-19’s impact on oncology. A full list of our coverage, as well as the latest meeting cancellations, is available here.
A telesitevisit? No, this is not a typo.
Like so much else in our neo-Zooming, Webexed lives, the cancer center site visit, that much-anticipated—and sometimes feared—rite of passage for those who yearn to earn, upgrade, or retain an NCI designation, has gone virtual.
If there’s telehealth, why shouldn’t there be a telesitevisit?
Adapting to COVID-19 travel bans, NCI has moved site visits online—and nary a kvetch has been heard by The Cancer Letter.
Four cancer centers were due for site visits in May: UNC Lineberger Comprehensive Cancer Center, the Abramson Cancer Center of the University of Pennsylvania, Karmanos Cancer Institute, and The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute.
All four institutions decided to proceed with the virtual option instead of delaying the Cancer Center Support Grant site visits to the fall.
“We all knew that our site visits were going to be in May, and as COVID-19 became more widespread, we knew there were going to be issues,” Shelton Earp, director of UNC Lineberger and the Lineberger Distinguished Professor of Cancer Research, said to The Cancer Letter. “NCI contacted the four centers separately in the beginning and asked us if we actually wanted to delay the site visit to the fall, because they thought that there wouldn’t be a chance for an in-person site visit in May. And, of course, they were correct with that.
“The core grant is at least a 12-month process, and so, we were ready. I felt, and our institution felt, that the travel bans were not going to be lifted by August and September.”
Virtual site visits are a new thing. So, how does NCI transport a multi-day in-person visit, as well as multiple teams, presentations, and discussions, into the Zoomiverse?
NCI has been receptive to the idea of virtual site visits from the beginning, Earp said.
Are home internet connections reliable?
“It was David Darr, the UNC associate director, who came up with the idea, ‘Well, why don’t we record the slide show and the talks?’” Earp said. “And everybody came to the conclusion that that would be a more failsafe way to do it, that you would introduce yourself, you would press a button, your slide show would come on, and you would give your presentation, and then you would come back live.
“The idea of pre-recording the talks, I think, was key to making this run on time and without problems.”
The approach worked at Chapel Hill, and two more virtual site visits have since been completed.
“Penn’s Abramson Cancer Center underwent its CCSG site visit two weeks ago under an entirely virtual format,” Robert Vonderheide, director of the Abramson Cancer Center, said to The Cancer Letter. “All the hard work from the NCI to conduct a virtual site visit of this scale, and no delay because of COVID-19, speaks volumes, in my opinion, to the national commitment and vital imperative to continue cancer research even during the pandemic.”
NCI’s virtual process was streamlined and well-organized, said Gerold Bepler, president and CEO of Karmanos Cancer Institute.
“The site visitors were very professional and we are pleased to report that the visit was flawless; we have no complaints about the process,” Bepler said to The Cancer Letter. “Although we prefer in-person site visits, we are grateful for the swift adaptation that allowed us to complete the visit virtually during these unprecedented times.”
The site visitors did exactly what they would normally do, UNC’s Earp said.
“They got together the night before on Webex from their own homes, and they discussed and came up with a list of questions,” Earp said. “And then, when the presentations were done, the site visit chair had the people that were going to review that group ask questions. So, the question and answers were very similar to what one would have at a regular site visit. It is different, not looking at the body language in the same way, but it was quite good. And I was pleased with it.
“There was an agenda, just like there would be at a site visit, and it was adhered to. The overview gets 30 minutes and 20 minutes for questions, and virtually all the rest of the presentations are 10 minutes, and 10 minutes for questions.”
It’s possible that virtual site visits may be here to stay, or remain a viable option if an in-person visit isn’t optimal.
“If, for example, a year from now we have a vaccine and everybody is comfortable, it’s not clear that some site visits wouldn’t go on this way,” Earp said. “I think it’s going to be interesting to see what comes out of it. I’ve read some of The Cancer Letter’s articles about COVID-19, I don’t think any of us know what 12 to 18 months is going to bring, both in clinical care and financing, and how we do research.
“And all of these things are going to be up in the air, but I think this is one thing that we don’t need to worry about. It can be done, I think, in a professional manner and well.”
Raphael Pollock, director of the OSUCCC – James, is getting ready for his center’s turn on the screen at the end of the month.
“We have been pleased with how the virtual site visit preparations have been going and the willingness and ease of the NCI to work closely with us to ensure a secure and fair process,” Pollock, who is also the surgeon-in-chief for the OSUCCC – James and The Ohio State University Health Care System, said to The Cancer Letter. “We’ve been very comfortable with this.
“We have spent a lot of time preparing our presentations, taping them, analyzing them as a group—probably on the order of 30 hours a week, minimum, in group activities—and optimizing the use of Webex. It’s a new skill set for most of us.”
Other cancer centers that may be working up to a virtual site visit might want to consider making extra time to prepare, Pollock said.
“If there was one caveat, I would recommend that my colleagues elsewhere budget enough time, because it’s truly amazing how much time it takes—I suspect longer than a more traditional on-site approach, even, just to be certain that the web connectivity and those types of issues are really there,” Pollock said. “We’ve been very fortunate, we have very strong IT support in the cancer center. I think that’s a necessity, because none of us have the computer expertise to handle it on our own.”
For Pollock, the virtual process was also an intensive exercise in acquainting leadership with the cancer center’s programs and activities.
“The other aspect is that, for me as a new director, it has been a tremendous learning experience, about the connectivity between different components in the cancer center,” Pollock said. “Because I’ve been hearing it in presentations, literally for the past two months, I am much more aware, just on the basis of repetition, and probably would not have had an easier time extracting this information simply from our written application, even though we were all very involved in its production.
“There’s something about hearing this repeatedly from different presenters and hearing the potential questions that might be asked at the time of the site visit that really focuses your attention.
“I’m grateful for that aspect of the process.”
The question and answers were very similar to what one would have at a regular site visit. I was pleased with it.
H. Shelton Earp, III, MD
Distinguished Professor; Lineberger Professor of Cancer Research; Director, UNC Lineberger Comprehensive Cancer Center;
Director, UNC Cancer Care;
The University of North Carolina at Chapel Hill
All the hard work from the NCI to conduct a virtual site visit of this scale … speaks to the national commitment and vital imperative to continue cancer research even during the pandemic.
Robert H. Vonderheide, MD, DPhil
John H. Glick Abramson Cancer Center Professor; Director, Abramson Cancer Center;
Vice dean, Cancer Programs, Perelman School of Medicine;
Vice president, Cancer Programs, University of Pennsylvania Health System, University of Pennsylvania
We have been pleased with how the virtual site visit preparations have been going and the willingness and ease of the NCI to work closely with us to ensure a secure and fair process.
Raphael E. Pollock, MD, PhD
Director, The Ohio State University Comprehensive Cancer Center;
Vice chair, clinical affairs, OSUCCC – James;
Professor, Division of Surgical Oncology;
Director, Sarcoma Research Laboratory, The Ohio State University
The site visitors were very professional and we are pleased to report that the visit was flawless; we have no complaints about the process.
Gerold Bepler, MD, PhD
President, CEO, Barbara Ann Karmanos Cancer Institute,
Wayne State University