NYU Grossman School of Medicine is one of four recipients of a National Cancer Institute grant to advance a national telehealth research agenda focused on improving cancer-related care and outcomes as part of the White House’s Cancer Moonshot 2.0. Led by principal investigators Scott E. Sherman, MD, MPH, and Danil V. Makarov, MD, MHS, of NYU Langone and the VA NY Harbor Healthcare System, and Leah Zullig, PhD, MPH, of Duke University and the Durham Center of Innovation to Accelerate Discovery and Practice Transformation, the Telehealth Research and Innovation for Veterans with Cancer (THRIVE) Center aims to understand the impacts of social determinants of health on delivery and outcomes of telehealth care for cancer, in other words, the social determinants of telehealth.

The VA is the largest integrated healthcare system in the United States, providing care to 6.7 million patients across 171 medical centers and 1,112 outpatient sites. A particular focus of the VA’s research has been to reduce disparities in care. As an equal access system without focus on provider reimbursement, the VA provides an outstanding and unique national laboratory to examine health equity and disparities in care.

The overarching aim of the THRIVE Center is to use the tools of implementation science to assess health equity as the VA continues to evolve to include telehealth as a routine part of cancer care. The center has two aims:

• to understand how social determinants of telehealth (SDTH), such as structural racism or bias, poverty, and rurality, impact the delivery of telehealth for cancer
• to develop methods to address SDTH and thereby improve access and quality of cancer care (with a particular focus on lung, colon, breast, and prostate) for all patients

In addition to these overarching aims, THRIVE comprises the following set of cores, each of which pursues a primary specific aim:

• Research and Methods Core: to identify the impact of SDTH on disparities in telehealth use for cancer care and on overall quality of care, and to develop and test implementation strategies to mitigate disparities
• Pragmatic Trial: to conduct a trial assessing the impact of a comprehensive, multilevel virtual oncology program on promoting engagement with telehealth and reducing SDTH-related care disparities
• Scholars Program: to train the next generation of oncology researchers in virtual care and health equity
• Clinical Practice Network: to create a high-functioning learning network that facilitates research on telehealth for cancer