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How Equity and Quality Are Considered by Cancer Centers Offering Practice-Integrated Telehealth Visits: A Qualitative
Lauren Jordan Barrow1,2, Ilona Fridman3, Regina Jones4
1Department of Health Policy and Management, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
The Permanente Journal
|August 4, 2026
Summary
Cancer centers
Area of Science:
- Health Services Research
- Oncology
- Digital Health
Background:
- The COVID-19 pandemic accelerated telehealth adoption in healthcare.
- The quality and equity of telehealth in oncology remain underexplored.
- This study examines how US cancer centers approach telehealth quality and equity.
Purpose of the Study:
- To investigate the integration of quality and equity considerations in oncology telehealth implementation.
- To understand practitioners' perceptions of telehealth quality and equity in cancer care.
- To identify barriers and facilitators to equitable telehealth delivery in oncology.
Main Methods:
- Qualitative study utilizing semistructured interviews with oncology practitioners.
- Interviews conducted between October 2021 and January 2023.
- Thematic analysis of transcribed interview data.
Main Results:
- Organizational diversity, equity, and inclusion (DEI) efforts were conceptual and disconnected from telehealth services.
- Actions addressing equity and quality were largely reactive, not proactive.
- Equity was often misunderstood as providing identical care to all patients.
- Telehealth quality and equity were not systematically measured or prioritized.
Conclusions:
- Existing organizational DEI initiatives did not translate into operational practices for oncology telehealth.
- There is limited organizational maturity in DEI and a lack of accountability for equity and quality in telehealth.
- Achieving high-quality, equitable oncology telehealth requires moving beyond awareness to concrete strategies and policies.
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