University of Pennsylvania, Philadelphia, PA
Christopher Manz , Nancy N. Baxter , Nefertiti C. duPont , Merry Jennifer Markham , Caitlin Drumheller , Lela Durakovic , Angela Kennedy
Background: Rarely used in routine practice pre-pandemic, telehealth utilization for cancer care rose significantly during the COVID-19 pandemic. Increased familiarity with telehealth has led to calls to continue its use after the pandemic ends. Yet national patterns of oncology telehealth utilization by visit type, preferences for telehealth use post-pandemic and barriers to telehealth for patients with cancer have not been described. Methods: 9,336 survey invitations were emailed to US-based ASCO members who have agreed to receive communications. Survey distribution was equally divided over five US regions, and practice type (e.g., academic, community) was reflective of ASCO membership proportions. The survey was open and data collected from January 4-28, 2021. Non-respondents received two reminder emails at week intervals. Analysis is descriptive. Results: 200 respondents completed the survey (2%). Respondents were 72% medical oncologists, 66% urban, 64% academic-affiliated, and from 42 states. 99% currently offered telehealth. 63% used telehealth for <=30% of all patient visits in the last 30 days; 18% used telehealth for more than half of visits. Telehealth utilization varied by visit type (table). 64% reported that the care delivered in telehealth visits was similar quality to in-person visits (29% worse). Assuming no regulatory or financial barriers to telehealth use after the pandemic, 92% would like to use telehealth for at least some visit types; only 8% prefer not to use telehealth. 20% would like to use telehealth for all visits types, and 64%, 54%, 33% and 17% would like to use telehealth for survivorship, symptom management, evaluation of patients receiving treatment and new patient visits, respectively (multiple selections allowed). Major barriers to telehealth were lack of patient access to technology (reported by 81%), limited patient technological proficiency (80%), language barriers (45%), uncertainty about future reimbursement (41%) and lack of administrative resources to support clinicians (33%). 68% agreed that the barriers increase cancer care disparities. Conclusions: Telehealth utilization was widespread during the COVID pandemic and varied by visit type. Most respondents plan to use telehealth in the future, but report barriers to continued use that worsen disparities.
% reporting for each visit type | No telehealth visits | < half | ≥ half |
---|---|---|---|
New patient | 28 | 50 | 22 |
Consent | 33 | 52 | 16 |
Evaluation for patients receiving systemic therapy | 23 | 53 | 24 |
Post surgery/radiation | 35 | 44 | 21 |
Survivorship | 9 | 40 | 51 |
Symptom management | 7 | 55 | 37 |
Discussion of important results | 10 | 54 | 36 |
Discussion of goals of care | 26 | 55 | 19 |
*Each cell is the percent of respondents who reported none, < half, or ≥ half of visits of the visit type in the last 30 days occurred as telehealth. Rows may not sum to 100 due to rounding.
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Abstract Disclosures
Funded by Conquer Cancer
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