Telemedicine’s Role in Bridging Cancer Care Gaps: Clark Alsfeld, MD

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Geographical and technological barriers remain a challenge for some patients seeking oncology care despite advancements in telemedicine, explained panelists at the population health–based Institute for Value-Based Medicine® (IVBM) in New Orleans, Louisiana, on November 4.

Financial barriers to care remain paramount in the conversation of equitable access to health care, said Clark Alsfeld, MD, oncology and hematology specialist at Ochsner MD Anderson, in an interview with The American Journal of Managed Care® (AJMC®). Yet, despite major advancements in telemedicine and virtual care, limited access to devices, like phones, tablets, or computers, required to utilize such tools persists, he said. Furthermore, geographical limitations, especially for patients who live in rural areas, may mean they do not have access to disease specialists or oncologists.

“Not everybody has access to a cell phone or a computer where they can access a virtual visit,” Alsfeld said. “Certainly, telephone calls are a good backup to that, but we even run into challenges there.”

Nevertheless, Ochsner MD Anderson's multiple cancer centers and community of local, statewide, and interstate oncologists connected with telemedicine have bridged financial gaps for many patients, Alsfeld said. With telemedicine, they don’t have to travel as far for medications or treatments. Furthermore, their community of pharmacists has also helped bridge gaps in access to care.

“There are a lot of different variables here and limiting access to care,” Alsfeld said. “But it is exciting to see the use now of telemedicine as a bridge to at least eliminate for some patients one barrier to care.”

Prior authorizations are also another barrier patients and physicians face, Asfeld said. Oftentimes, he expressed, there are gaps between the standard of care for certain diseases, which may change based on newer research and insurance companies’ awareness of such, thus prolonging patients’ time to treatment.

For example, Alsfeld cited the case of a 27-year-old woman who was diagnosed with Philadelphia-positive acute lymphoblastic leukemia (ALL). The standard of care for patients with ALL is concurrent therapy with blinatumomab, an immunotherapy, and ponatinib, a tyrosine kinase inhibitor.1 He also emphasized that prior research supports this newer standard of care with greater efficacy and tolerability for her age group. Yet, the patient’s insurance was still reluctant to approve ponatinib as part of her treatment.

“I think that's an area where still reform is needed, and having us work with the payer mix and also the governing bodies and regulatory bodies to try to make sure that all of our patients get the same access to care,” Alsfeld said.

Nevertheless, Alsfeld said he believes they are making headway with some insurance companies that are willing to adapt policies and approvals to reflect newer research and therefore an updated standard of care. Additionally, telemedicine, although some barriers are still persistent, has eliminated substantial financial barriers for Asfeld’s patients, he said.

“Really, through access to telemedicine, we can bridge the gap between specialists and patients and maintain patients and treat them where they want to receive their care,” he said.

Reference

1. Patient guidelines: acute lymphoblastic leukemia. Plymouth Meeting, PA: National Comprehensive Cancer Network; 2025. Accessed November 17, 2025. https://www.nccn.org/patients/guidelines/content/PDF/all-patient.pdf