Adoption of telemedicine (Telemed) by medical oncologists/hematologists (mO/H) during the COVID-19 pandemic.

Abstract

285 Background: The COVID-19 pandemic has dramatically impacted access to and delivery of healthcare in the U.S. At the height of the pandemic, many practices began initiating or increasing telemed visits to meet care demands in a quarantined environment. The objective of this descriptive study was to assess mO/H perceptions of benefits and barriers to current and post-pandemic use of telemed in oncology. Methods: Web-based surveys were fielded to mO/H before virtual meetings held between September and November 2020. Participants submitted their demographic information and responses to questions about pandemic impacts on their practice and patients. Responses were aggregated and analyzed using descriptive statistics. Results: A total of 259 mO/H across the U.S. completed the survey; 73% practice in a community setting; 44% identify as hospital employees. The participants spend a median of 90% of their working time in direct patient care, have a median of 18 years of clinical experience, and see a median of 20 patients per day on clinic days. Before the pandemic, 92% of the participants’ practices had telemed capabilities but of those, 77% were not utilizing telemed for any visits. During the pandemic, almost all the participants’ practices were offering telemed, with 97% reporting some patient visits being conducted via telemed. Most (78%) anticipate continuing to offer or conduct some patient visits via telemed. Two-thirds stated that up to 25% of their patient visits could be converted to telemed outside of a pandemic environment. The types of visits that most believe are suitable for telemed include reviewing test/lab results, routine surveillance of chronic conditions, and survivorship care visits. Most (60%) stated that their patients view telemed favorably. About half reported a positive overall experience with telemed, with 47% reporting a better-than-expected experience. Most (79%) estimated that pivoting to telemed equates to a revenue loss of up to 50% for that visit; 53% feel that telemed has had an overall negative financial impact on their practice. Two-thirds have experienced challenges getting reimbursed for telemed claims. The most common challenges with telemed reported were reluctance or inability of patients to participate in telemed (39%) and technology challenges (37%). The most common benefit of telemed reported was safety, i.e., less potential exposure to COVID-19 for providers and staff (65%). Conclusions: Telemed use was infrequent before the pandemic, but utilization has dramatically increased during the pandemic. Despite favorable experiences with telemed, mO/H expect telemed use to decline significantly post-pandemic. This prediction may be driven by the perceived loss of revenue when an in-person visit is converted to telemed visit. Further research is needed in identifying factors that may allow for the long-term adoption of telemed for appropriate patients.