Alejandro Berlin1,2,3,4, Mike Lovas1,5, Tran Truong2,3, Sheena Melwani1, Justin Liu3, Zhihui Amy Liu6,7, Adam Badzynski5, Mary Beth Carpenter8, Carl Virtanen8, Lyndon Morley6, Onil Bhattacharyya9, Marnie Escaf6, Lesley Moody6, Avi Goldfarb10, Luke Brzozowski2,3, Joseph Cafazzo3,5,11, Melvin L K Chua12,13,14, A Keith Stewart6,15, Monika K Krzyzanowska6,16. 1. Smart Cancer Care Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. 2. Data Science Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. 3. Techna Institute, University Health Network, Toronto, Ontario, Canada. 4. Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 5. Healthcare Human Factors, University Health Network, Toronto, Ontario, Canada. 6. Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. 7. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 8. University Health Network Digital, University Health Network, Toronto, Ontario, Canada. 9. Women's College Hospital, Toronto, Ontario, Canada. 10. Rotman School of Management, University of Toronto, Toronto, Ontario, Canada. 11. eHealth Innovation, University Health Network, Toronto, Ontario, Canada. 12. Division of Radiation Oncology, National Cancer Centre Singapore, Singapore. 13. Division of Medical Sciences, National Cancer Centre Singapore, Singapore. 14. Oncology Academic Programme, Duke-NUS Medical School, Singapore. 15. Ontario Health, Cancer Care Ontario, Ontario, Canada. 16. The Cancer Quality Lab, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Abstract
Importance: The coronavirus disease 2019 (COVID-19) pandemic has burdened health care resources and disrupted care of patients with cancer. Virtual care (VC) represents a potential solution. However, few quantitative data support its rapid implementation and positive associations with service capacity and quality. Objective: To examine the outcomes of a cancer center-wide virtual care program in response to the COVID-19 pandemic. Design, Setting, and Participants: This cohort study applied a hospitalwide agile service design to map gaps and develop a customized digital solution to enable at-scale VC across a publicly funded comprehensive cancer center. Data were collected from a high-volume cancer center in Ontario, Canada, from March 23 to May 22, 2020. Main Outcomes and Measures: Outcome measures were care delivery volumes, quality of care, patient and practitioner experiences, and cost savings to patients. Results: The VC solution was developed and launched 12 days after the declaration of the COVID-19 pandemic. A total of 22 085 VC visits (mean, 514 visits per day) were conducted, comprising 68.4% (range, 18.8%-100%) of daily visits compared with 0.8% before launch (P < .001). Ambulatory clinic volumes recovered a month after deployment (3714-4091 patients per week), whereas chemotherapy and radiotherapy caseloads (1943-2461 patients per week) remained stable throughout. No changes in institutional or provincial quality-of-care indexes were observed. A total of 3791 surveys (3507 patients and 284 practitioners) were completed; 2207 patients (82%) and 92 practitioners (72%) indicated overall satisfaction with VC. The direct cost of this initiative was CAD$ 202 537, and displacement-related cost savings to patients totaled CAD$ 3 155 946. Conclusions and Relevance: These findings suggest that implementation of VC at scale at a high-volume cancer center may be feasible. An agile service design approach was able to preserve outpatient caseloads and maintain care quality, while rendering high patient and practitioner satisfaction. These findings may help guide the transformation of telemedicine in the post COVID-19 era.
Importance: The coronavirus disease 2019 (COVID-19) pandemic has burdened health care resources and disrupted care of patients with cancer. Virtual care (VC) represents a potential solution. However, few quantitative data support its rapid implementation and positive associations with service capacity and quality. Objective: To examine the outcomes of a cancer center-wide virtual care program in response to the COVID-19 pandemic. Design, Setting, and Participants: This cohort study applied a hospitalwide agile service design to map gaps and develop a customized digital solution to enable at-scale VC across a publicly funded comprehensive cancer center. Data were collected from a high-volume cancer center in Ontario, Canada, from March 23 to May 22, 2020. Main Outcomes and Measures: Outcome measures were care delivery volumes, quality of care, patient and practitioner experiences, and cost savings to patients. Results: The VC solution was developed and launched 12 days after the declaration of the COVID-19 pandemic. A total of 22 085 VC visits (mean, 514 visits per day) were conducted, comprising 68.4% (range, 18.8%-100%) of daily visits compared with 0.8% before launch (P < .001). Ambulatory clinic volumes recovered a month after deployment (3714-4091 patients per week), whereas chemotherapy and radiotherapy caseloads (1943-2461 patients per week) remained stable throughout. No changes in institutional or provincial quality-of-care indexes were observed. A total of 3791 surveys (3507 patients and 284 practitioners) were completed; 2207 patients (82%) and 92 practitioners (72%) indicated overall satisfaction with VC. The direct cost of this initiative was CAD$ 202 537, and displacement-related cost savings to patients totaled CAD$ 3 155 946. Conclusions and Relevance: These findings suggest that implementation of VC at scale at a high-volume cancer center may be feasible. An agile service design approach was able to preserve outpatient caseloads and maintain care quality, while rendering high patient and practitioner satisfaction. These findings may help guide the transformation of telemedicine in the post COVID-19 era.
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Authors: Eleni Giannopoulos; Ankit Agarwal; Jennifer Croke; Daniel W Golden; Ariel E Hirsch; Rachel B Jimenez; Nauman H Malik; Janet Papadakos; Naa Kwarley Quartey; Diana Samoil; Che Hsuan David Wu; Paris-Ann Ingledew; Meredith Giuliani Journal: J Cancer Educ Date: 2022-06-20 Impact factor: 1.771
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Authors: Tuya Pal; Pamela C Hull; Tatsuki Koyama; Phillip Lammers; Denise Martinez; Jacob McArthy; Emma Schremp; Ann Tezak; Anne Washburn; Jennifer G Whisenant; Debra L Friedman Journal: BMC Cancer Date: 2021-11-23 Impact factor: 4.430