David Hsiehchen1, Maishara Muquith2, Waqas Haque2, Magdalena Espinoza3, Adam Yopp4, Muhammad S Beg1. 1. Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX. 2. University of Texas Southwestern Medical School, Dallas, TX. 3. Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX. 4. Division of Surgical Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
Abstract
PURPOSE: Telehealth has been an integral response to the COVID-19 pandemic. However, no studies to date have examined the utility and safety of telehealth for oncology patients undergoing systemic treatments. Concerns of the adequacy of virtual patient assessments for oncology patients include the risk and high acuity of illness and complications while on treatment. METHODS: We assessed metrics related to clinical efficiency and treatment safety after propensity matching of newly referred patients starting systemic therapy where care was in large part replaced by telehealth between March and May 2020, and 206 newly referred patients from a similar time period in 2019 where all encounters were in-person visits. RESULTS: Patient-initiated telephone encounters that capture care or effort outside of visits, time to staging imaging, and time to therapy initiation were not significantly different between cohorts. Similarly, 3 month all-cause or cancer-specific emergency department presentations and hospitalizations, and treatment delays were not significantly different between cohorts. There were substantial savings in travel time with virtual care, with an average of 211.4 minutes saved per patient over a 3-month interval. CONCLUSION: Our results indicate that replacement of in-person care with virtual care in oncology does not lead to worse efficiency or outcomes. Given the increased barriers to patients seeking oncology care during the pandemic, our study indicates that telehealth efforts may be safely intensified. These findings also have implications for the continual use of virtual care in oncology beyond the pandemic.
PURPOSE: Telehealth has been an integral response to the COVID-19 pandemic. However, no studies to date have examined the utility and safety of telehealth for oncology patients undergoing systemic treatments. Concerns of the adequacy of virtual patient assessments for oncology patients include the risk and high acuity of illness and complications while on treatment. METHODS: We assessed metrics related to clinical efficiency and treatment safety after propensity matching of newly referred patients starting systemic therapy where care was in large part replaced by telehealth between March and May 2020, and 206 newly referred patients from a similar time period in 2019 where all encounters were in-person visits. RESULTS: Patient-initiated telephone encounters that capture care or effort outside of visits, time to staging imaging, and time to therapy initiation were not significantly different between cohorts. Similarly, 3 month all-cause or cancer-specific emergency department presentations and hospitalizations, and treatment delays were not significantly different between cohorts. There were substantial savings in travel time with virtual care, with an average of 211.4 minutes saved per patient over a 3-month interval. CONCLUSION: Our results indicate that replacement of in-person care with virtual care in oncology does not lead to worse efficiency or outcomes. Given the increased barriers to patients seeking oncology care during the pandemic, our study indicates that telehealth efforts may be safely intensified. These findings also have implications for the continual use of virtual care in oncology beyond the pandemic.
Authors: Sadiq Y Patel; Ateev Mehrotra; Haiden A Huskamp; Lori Uscher-Pines; Ishani Ganguli; Michael Lawrence Barnett Journal: Health Aff (Millwood) Date: 2021-02 Impact factor: 6.301
Authors: W R Hersh; M Helfand; J Wallace; D Kraemer; P Patterson; S Shapiro; M Greenlick Journal: BMC Med Inform Decis Mak Date: 2001-11-26 Impact factor: 2.796
Authors: Clemens Scott Kruse; Nicole Krowski; Blanca Rodriguez; Lan Tran; Jackeline Vela; Matthew Brooks Journal: BMJ Open Date: 2017-08-03 Impact factor: 2.692
Authors: Benjamin Noah; Michelle S Keller; Sasan Mosadeghi; Libby Stein; Sunny Johl; Sean Delshad; Vartan C Tashjian; Daniel Lew; James T Kwan; Alma Jusufagic; Brennan M R Spiegel Journal: NPJ Digit Med Date: 2018-01-15
Authors: Lisa M Koonin; Brooke Hoots; Clarisse A Tsang; Zanie Leroy; Kevin Farris; Tilman Jolly; Peter Antall; Bridget McCabe; Cynthia B R Zelis; Ian Tong; Aaron M Harris Journal: MMWR Morb Mortal Wkly Rep Date: 2020-10-30 Impact factor: 17.586
Authors: Molly M Jeffery; Gail D'Onofrio; Hyung Paek; Timothy F Platts-Mills; William E Soares; Jason A Hoppe; Nicholas Genes; Bidisha Nath; Edward R Melnick Journal: JAMA Intern Med Date: 2020-10-01 Impact factor: 21.873
Authors: Ana I Velazquez; Urshila Durani; Lachelle D Weeks; Ajay Major; Robby Reynolds; Ashok Kumbamu; Devika G Das; Martina C Murphy; Elizabeth Henry; Alfred I Lee; Ariela L Marshall Journal: JCO Oncol Pract Date: 2022-01-11