Community-Based Telehealth Approach Improves Specialist Access for Individuals with Increased Cancer Risk in Low-Resource Settings

Background/Objectives: The low-resource, minority and underserved populations (LRMU) that carry the highest risk of oral cancer (OC) experience many barriers to early detection and treatment, resulting in disproportionately poor outcomes. One major barrier to better outcomes is poor compliance with specialist referral for diagnosis and treatment. The goal of this prospective study was to compare specialist referral compliance for Telehealth vs. in-person visits in LRMU individuals screening positive for increased OC risk. Methods: Forty subjects who had screened positive for oral potentially malignant lesions (OPMLs) were recruited from community clinics. The subjects indicated whether they would prefer an in-person or Telehealth specialist visit. They were offered assistance with all aspects of the visit, and then tracked over 3 months for referral compliance. A novel, very low-cost, simple Telehealth platform located within the community clinic was used for the remote specialist visits. Results: In the Telehealth group, 16/24 subjects attended their first scheduled remote specialist visit; 4/24 attended rescheduled visits within 3 months, and 4/24 did not comply at all. All attendees and specialists were able to complete the remote visits in full. Of the 7/16 subjects who completed in-person visits, 3/16 attended their first scheduled visit, and 4/16 complied within 3 months; 9/16 subjects did not comply at all with specialist referral. Significantly more individuals complied with Telehealth specialist referral at 1 month (p = 0.0006) and after 3 months (p = 0.0154). Conclusions: This novel Telehealth platform may improve compliance with specialist referral in low-resource individuals with OPMLs.