West Michigan Cancer Center, Kalamazoo, MI
David I. Shalowitz, Cheyenne R. Wagi, Aliza Randazzo, Alexandra G. Peluso, Sarah A. Birken
Background: Gynecologic cancers are among the most prevalent cancers in women, yet many patients do not receive guideline-concordant care, in part due to lack of geographic access to gynecologic oncologists (Gyn Onc). Telemedical technology allows patients’ local physicians to consult with subspecialist Gyn Oncs, without burdening patients with unnecessary in-person visits. Providers’ acceptance of provider-to-provider telemedicine consultation for the management of gynecologic cancers is unknown. We aimed to gather feedback about experiences with referrals, communication, and openness to telemedical consultation between Gyn Oncs, gynecologists (Gyn) and medical oncologists (Med Onc). Methods: Gyn Onc, Gyn, and Med Onc physicians were recruited from practices serving rural patient populations to participate in semi-structured interviews. As implementation of telemedicine interventions is influenced by factors at multiple levels, the Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF) guided the interview. Questions focused on barriers and facilitators to provider-to-provider telemedicine consultation stemming from inner/outer settings and individual experiences. Interviews were conducted via WebEx, recorded, and transcribed. Two coders established analytic reliability with two transcripts and independently coded remaining interviews using a combined CFIR-TDF framework. Codes were analyzed and combined into salient themes. Results: We conducted 11 interviews (6 Gyn Onc, 3 Gyn, 2 Med Onc). We identified six themes (Table 1). Themes included hesitancy to adopt new methods of communication, frustration with existing methods, and potential gaps that could be filled by a cloud-based asynchronous platform. Conclusions: Providers experience burnout from communication and are hesitant to adopt a new platform. Providers note referrals with providers using different EHR systems is difficult, as they cannot share patient records easily and securely. Providers are open to adopting provider-to-provider telemedicine consultation if the system can be streamlined to share patient records easily.
Themes |
---|
Providers are overwhelmed by existing communication channels (EHR, phone, fax, pagers, text) |
Providers are concerned about burnout, increased work volume, interruptions to workflow, and effectiveness of communication |
Providers want more information about accountability and compensation in using a formalized consultation platform |
Some Gyns feel there is a barrier to reaching out to Gyn Oncs and Med Oncs when there is not an existing relationship; specialists are frustrated by lack of information sharing or previous testing from referrals |
Providers find it difficult to share patient information with other providers not on the same EHR system |
Providers felt that telemedicine consultation could improve patient access to specialized care |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2023 ASCO Annual Meeting
First Author: Alison Tray
2020 ASCO Quality Care Symposium
First Author: Avnish K Bhatia
2024 ASCO Quality Care Symposium
First Author: M. Kelsey Kirkwood
2019 ASCO Annual Meeting
First Author: Chadi Nabhan