Telehealth in multidisciplinary target delineation for radiotherapy during the COVID-19 pandemic. A review and a case.

Jensen, Kenneth; Dalby, Rikke Beese; Bouchelouche, Kirsten; Pedersen, Erik Morre; Kalmar, Stefan

Like all other medical specialities, radiotherapy has been deeply influenced by the COVID-19 pandemic. The pandemic has had severe influence on the entire patient trajectory in oncology, from diagnosis to treatment and follow-up. Many examples of how to deal with patient and staff safety, shortness of staff and other resources and the quest to continue high-quality, evidence-based treatment have been presented. The use of telemedicine and telehealth is frequently presented as a part of the solution to overcome these challenges. Some of the available presented solutions will only apply in an acute, local setting, whereas others might inspire the community to improve quality and cost-effectiveness of radiotherapy as well as knowledge sharing in the future. Some of the unresolved issues in many of the available technical solutions are related to data security and public regulation, e.g., GDPR (General Data Protection Regulation) in the EU and HIPAA compliance (Health Insurance Portability and Accountability Act) in the USA. Using a solution that involves a supplier's server in a non-EU country is problematic within the EU. In this paper we shortly review the influence of COVID-19 on radiotherapy. We describe some of the possible solutions for telehealth in target delineation – a crucial part of high-quality radiotherapy, which often requires multidisciplinary effort, hands-on corporation, and high-quality multimodal imaging. Hereafter, our own technical solution will be presented as a case.