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UNC Lineberger’s Jennifer Elston Lafata, PhD.

Genentech has awarded UNC Lineberger Comprehensive Cancer Center’s Jennifer Elston Lafata, PhD, a two-year, $750,000 ​Health Equity​ Innovations Fund grant to study how health care organizations are considering equity as they establish new virtual visit programs in cancer care, and how these programs can improve cancer care access, quality and patient outcomes. The research will be done in partnership with the Henry Ford Health System in Detroit and in collaboration with community, patient and family advisors to enhance the relevance and usefulness of study findings.

“The rapid scaling of virtual cancer visits during the pandemic has created an unprecedented need for and context in which to study the implementation successes, challenges and opportunities afforded by virtual visits, especially as they pertain to achieving equity in care access and reducing racial disparities in outcomes,” said Lafata, who is a professor and vice chair of Pharmaceutical Outcomes and Policy at the UNC Eshelman School of Pharmacy and co-lead of UNC Lineberger’s Cancer Care Quality Initiative.

Lafata and her colleagues, including UNC Lineberger’s Trevor Royce, MD, MS, MPH, Angela Smith, MD, MS, and William Wood, MD, MPH, will focus their research on two overarching practice-relevant questions: How are oncology care organizations considering equity as they design new virtual visit programs, and how virtual visits may hinder or enhance care access and affect outcomes among Black adults diagnosed with cancer?

“We propose to use this real-world context to identify the patient-, organizational-, and community-level factors associated with equity in virtual visit access and disparities in patient outcomes,” Lafata said. “In so doing, we will identify ways to ensure virtual visit use going forward does not introduce new disparities or exacerbate well-known disparities in cancer.”

The researchers will conduct patient interviews to identify access barriers and facilitators of virtual visits among Black adults receiving oncology care from UNC Health and Henry Ford Health System, two health care organizations committed to serving the diverse needs of their catchment areas.

 They also will use merged electronic health records, patient surveys and community-level data to determine which patients receive virtual care (video, telephone or both) and to assess how virtual visit use is associated with patient-reported outcomes, clinical trial participation, and acute care events, including emergency department and hospital use, and how race may moderate the relationship between virtual visits and outcomes.

“It is clear to many that virtual visits, while implemented in response to the pandemic, will not disappear from the cancer care landscape as the pandemic wanes,” Lafata said. “Given this expectation, it is imperative that the cancer community consider not only how virtual care can enhance quality and outcomes, but also how virtual care can reduce, and not exacerbate, well-known disparities.”