ASO Author Reflections: The Patient Perspective of Telemedicine in Breast Cancer Care.

Past

Satisfaction and usability of telemedicine has been extensively studied across many different care disciplines.1 Much of this work took place when patients still traveled to local clinics to participate in telemedicine via video equipment provided by the clinic. As telemedicine has evolved to allow patients to utilize their own devices, literature assessing patient satisfaction and usability of telemedicine has not evolved in parallel, particularly in cancer care. The existing literature has indicated that oncology patients find telemedicine favorable in comparison with in-person care.2 However, no studies have assessed the views of patients with breast cancer across all oncologic subspecialties using a validated survey tool.

Present

Many health care systems rapidly accelerated their utilization of telemedicine as a result of the coronavirus disease 2019 (COVID-19) pandemic to mitigate infectious disease propagation. This adaptation in care delivery is especially important given the potential for increased infection risk and poor outcomes for patients diagnosed with cancer.3

Our study surveyed patients with breast cancer who have completed a telemedicine visit with a surgical, medical, or radiation oncologist, to assess satisfaction and usability of telemedicine. Patients were satisfied with telemedicine and found it usable across all oncologic subspecialties. Furthermore, a strong positive correlation between satisfaction and usability was observed with a Spearman correlation coefficient of 0.80 (p < 0.05). Satisfaction and usability scores remained stable across comparisons relative to various patient, visit, cancer, and treatment characteristics. However, in instances where patients had trouble connecting with their physician, statistically significant decreases in satisfaction and usability were apparent.4

Future

From the patient perspective, telemedicine may be a viable alternative care delivery method in breast cancer care moving forward. Further research aimed at directly comparing satisfaction and usability of telemedicine to that of in-person care may better inform the use of telemedicine outside of the COVID-19 pandemic. However, assessing the utility of telemedicine in the future must extend beyond the patient perspective. It is known that telemedicine severely restricts the process of conducting a physical examination.5 Thus, capturing the physician perspective will be paramount to delineating which oncologic subspecialties and which clinical situations may be more conducive to care delivery via telemedicine in the future.