Effect of a virtual oncology telemedicine advanced practice provider clinic on patient financial burden and access to care disparities in patients with new benign hematologic cancer.

Abstract

388 Background: Anemia is a significant part of healthcare burden in the US with 2.8 million visits per year (CDC Stat Facts, 2024). In a large community oncology/hematology practice of 200+ physical clinics/cancer centers throughout Texas, meeting benign hematology patient needs is challenging. Due to ever-increasing specialty physician shortages, patients are experiencing extended appointment access times and increased financial burden related to travel for New Patient appointments. Patients were waiting an average of 15.1 days from referral to initial provider appointment. A statewide quality improvement pilot was created allowing clinic providers the option to refer benign hematology patients to a Virtual APP (VAPP) clinic for the New Patient visit. Methods: This retrospective endeavor collected electronic medical record data over a 90-day pilot period from January-April 2024, to evaluate the time between referral received vs appointment completion. Additionally, the referred patients’ distance from home location to the nearest in-person clinic was calculated. Results: Implementation of a virtual APP New Patient clinic reduced the time from referral to first appointment from 15.1 days to 9 days for a 40% reduction in time to appointment. Within the pilot, 129 patients on average, would have traveled approximately 44 miles round trip to and from their home residence to the closest in person clinic. This resulted in a minimum mileage cost savings of $9.68 per patient, $1,248 cumulative. Additionally, these same 129 patients saved approximately 3.5 hours of work time by not taking time off for commute resulting in a 96.39 per patient, $12,434.31 cumulative, earned incoming savings based on average Texas salary. Conclusions: The VAPP clinic reduced patient access disparity for Benign Hematology appointments by over 40%. Utilization of a telemedicine-based platform, at a minimum, reduced the patients’ financial toxicity burden and impact by 106.06 per patient or 13,682.31 overall during the 90-day pilot period. Providing a virtual visit option for patients, allows quicker access to quality care, lessens time toxicity, and reduces financial burden associated with medical care in 2024.