Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA
Divya Ahuja Parikh, Jenni Chang, Lakedia Charman Banks, Manali I. Patel
Background: Teleoncology programs have emerged as an innovative approach to deliver cancer care, addressing barriers such as geographical distance and limited access to specialized services. The Veterans Health Administration (VHA) which is the largest integrated healthcare system in the United States has implemented teleoncology programs, including national programs through the National Teleoncology Program and more regional programs such as VISN Clinical Resource Hub (CRH), which operates under a hub-and-spoke model. This study aims to qualitatively evaluate the experience of veterans with prostate cancer within the regional VISN CRH teleoncology program. Methods: Veterans diagnosed with prostate cancer who were receiving oncology care through the VISN CRH teleoncology program for at least 3 months were recruited for interviews. The 1:1, 30 minute interviews were conducted using a semi-structured interview guide adapted from a prior telemedicine publication. Thematic analysis identified recurring patterns, categorized information, and major themes related to the veterans’ experiences in the program. Results: We interviewed 22 veterans (age 67-89) with prostate cancer, the majority were White (N=19, 86%) and with Stage IV disease (N=21, 95%) on oral, IV and/or injectable medical therapies (N=22, 100%). Five themes emerged: 1) reduced financial burden associated with teleoncology, including decreased costs of transportation and less time away from work; 2) improved convenience, including flexibility in scheduling appointments; 3) improved communication with care providers with clear understanding of instructions and treatment plans, even promoting more active patient engagement; 4) improved access to specialty care and care that veterans otherwise would not have access to; and 5) positive experiences outweighed concerns of lack of face-to-face contact. Conclusions: This qualitative study provides valuable insights into the teleoncology experience of veterans with prostate cancer. The veterans in this study describe reduced financial burden, increased engagement and improved access to subspecialty and other care. These findings highlight the importance of further evaluating the use of teleoncology programs to optimize cancer care delivery.
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