ASCO Speaks Out on COVID-19

As the COVID-19 incidence and mortality rates rise and the 2020 American coronavirus shutdown continues, professional medical organizations are doing everything possible to keep their members prepared and informed.

In a webinar on March 19, experts from the American Society of Clinical Oncology (ASCO), the world’s foremost professional organization for oncologists and other oncology professionals, detailed ASCO’s response to the ongoing COVID-19 crisis and resources the organization has made available to its members.

UPDATE 3/24/2020: ASCO Meeting Goes Virtual Due to COVID-19

ASCO Annual Meeting and Other Programs

The ASCO Annual Meeting, the largest oncology conference in the world each year, had been scheduled to take place in Chicago from May 29 to June 2, 2020. Although nothing is official at this point, the organization is weighing alternate scenarios for holding a virtual meeting.

“Regardless of the format, ASCO will host a robust educational and scientific program. Abstracts will be published online and in the Journal of Clinical Oncology as always. A final decision on the meeting format will be made soon to allow participants adequate time to adjust their plans,” Stephen S. Grubbs, MD, FASCO, ASCO’s vice president of Clinical Affairs, said on the webinar. “If the situation arises that we cannot have a face-to-face meeting, we will, effectively, follow our mission and have a virtual meeting.”

Grubbs also provided updates on key ASCO programs, including the Quality Oncology Practice Initiative (QOPI), which facilitates self-examination and improvement in outpatient-oncology practices. Regarding the QOPI certification program, Grubbs said, “Because of the pandemic, we have suspended all practice visits for audits in the foreseeable future. And practices that may be having their certifications lapse—that will not happen. The certification will remain in place until the situation improves where we can get back to doing the onsite surveys.”

Grubb’s also said that ASCO’s consulting services and engagement programs have suspended onsite visits and will now be doing tele-consulting support for practices involved with the programs.

ASCO Coronavirus (COVID-19) Oncology Resource Center

As the COVID-19 situation started to worsen, ASCO began to envision ways the organization could offer support to help inform providers across the entire cancer care spectrum. A first key step ASCO took was to ask their members to contribute questions that would subsequently be aggregated into an FAQ resource.

As the crisis worsened, and the questions and concerns from ASCO members mounted, the organization went from answering questions on an ad hoc basis to setting up an entire rapid response team to answer questions more efficiently and effectively.

“Some of the questions are more difficult to answer than others. We’re getting questions, such as whether to delay treatment, or otherwise alter the treatment path, which can have serious consequences. There’s also [the question of] what do we do if a provider gets infected, or a clinic is exposed. In some cases, we simply have to say, ‘We don’t know what’s the best practice to do.’ In other cases, we consult with a wider body of experts to make sure we get the right answer and we try to turn these questions around within a 24- to 48-hour period,” Thomas Oliver, director of ASCO’s Clinical Practice Guidelines Division, said on the webinar.

ASCO now has an entire Coronavirus (COVID-19) Oncology Resource Center on its site and Oliver said that, based on trends, the Q/A section is now divided into 3 areas: clinical care, practice operations, and state and national policy.

“With clinical care, we are using literature searches and expert insights from volunteers in ASCO clinical practice guideline programs to help you care for your patients,” said Grubbs.

The practice operations section involves practical application of CDC facility preparedness and infection control recommendations, and information from an expert panel of ASCO’s Clinical Practice Committee and Quality Care Council leadership.

Grubbs addressed a few matters related to practice operations on the webinar. He said oncology practices should have the CDC recommendations on how to protect yourself in public posted in their offices so patients can be reminded of the information in writing.

He also said oncologists should limit the entry points to their facilities, and that “patients and visitors should be screened upon arrival and before they actually enter into the waiting area. Patients with suspected infections should be immediately isolated.”

Regarding staff, Grubbs said, “All staff entering rooms with known or suspected infections should adhere to the standard precautions and use a respirator or facemask, as well as gowns, gloves, and eye protection.”

He added, “If you have personal who have not had infections prevention and control training, the World Health Organization has a training module that you can refer them to so they can learn how to do infection control.”

With the third category of questions, State and National Policy, ASCO provides answers to questions related to the CDC, CMS, and other regulatory updates and how they relate to oncology clinical practice.

Oliver said that as more questions come in and information becomes available, ASCO will be updating its Coronavirus (COVID-19) Oncology Resource Center on a rolling basis. However, he stressed that ASCO will not be including every detail related to COVID-19 in general on its resource page. “We’re trying to not clutter this resource center with every coronavirus-related resource we find. We’re really trying to keep it focused on what people are identifying as a cancer care gap.”

ASCO COVID-19 Legislative Update

ASCO also provided a legislative and regulatory update on the webinar.

“As has been widely reported, Congress has completed 2 and is working on at least 1 additional emergency relief package. ASCO is closely monitoring legislative activity and looking for opportunities to engage on issues of concern such as supply shortages, limited availability of tests, and practice viability, as these efforts move forward,” said Amanda Schwartz, ASCO’s director of Congressional Affairs.

One of the 2 relief packages, the $8.3 billion Coronavirus Preparedness & Response Supplemental Appropriates Act, was signed into law on March 6. “One notable inclusion in this package is $500 million to the CMS for expanded telehealth,” said Schwartz.

The potential third relief package Congress is working on is focusing on economic stimulus to impacted industries. “There have been calls from hospital and provider groups, such as the American Medical Association and the American Hospital Association, for this package to include surge funding to tackle supply and workforce shortages in healthcare, as well as further telehealth flexibility.”

“ASCO will continue to follow these developments closely and weigh in, as appropriate,” concluded Schwartz.

Also commenting on regulatory matters relevant to oncology professionals was Gina Baxter, an associate director at ASCO.

She said that that HHS issue 2 new HCPCS codes, which are used for billing Medicare and Medicaid patients. Code U0001 is for CDC lab testing for COVID-19 and code U0002 is for non-CDC lab testing for COVID-19. Baxter also focused on HHS guidance on telehealth for Medicare recipients in her segment of the webinar.

“Unlike telehealth as it existed before COVID-19, telehealth will now be a service that is available to all Medicare beneficiaries, regardless of geography—you don’t need to live in a rural area, anyone will have access to telehealth services,” she explained.

She also said that patients will be eligible to receive telehealth in their homes for all eligible telehealth services, not just those related to COVID-19.

Lastly, physicians can now accept new patients for telehealth. “Typically, telehealth has only been for established patients. During this public health emergency, HHS will not audit for prior relationship with the patients, which will enable physicians to see new patients,” said Baxter.