Abstract
BackgroundTo ensure safe delivery of oncologic care during the COVID-19 pandemic, telemedicine has been rapidly adopted. However, little data exist on the impact of telemedicine on quality and accessibility of oncologic care. This study assessed whether conducting an office visit for thoracic oncology patients via telemedicine affected time to treatment initiation and accessibility.MethodsThis was a retrospective cohort study of patients with thoracic malignancies seen by a multidisciplinary team during the first surge of COVID-19 cases in Philadelphia (March 1 to June 30, 2020). Patients with an index visit for a new phase of care, defined as a new diagnosis, local recurrence, or newly discovered metastatic disease, were included.Results240 distinct patients with thoracic malignancies were seen: 132 patients (55.0%) were seen initially in-person vs 108 (45.0%) via telemedicine. The majority of visits were for a diagnosis of a new thoracic cancer (87.5%). Among newly diagnosed patients referred to the thoracic oncology team, the median time from referral to initial visit was significantly shorter amongst the patients seen via telemedicine vs. in-person (median 5.0 vs. 6.5 days, p < 0.001). Patients received surgery (32.5%), radiation (24.2%), or systemic therapy (30.4%). Time from initial visit to treatment initiation by modality did not differ by telemedicine vs in-person: surgery (22 vs 16 days, p = 0.47), radiation (27.5 vs 27.5 days, p = 0.86, systemic therapy (15 vs 13 days, p = 0.45).ConclusionsRapid adoption of telemedicine allowed timely delivery of oncologic care during the initial surge of the COVID19 pandemic by a thoracic oncology multi-disciplinary clinic.
Highlights
To ensure safe delivery of oncologic care during the COVID-19 pandemic, telemedicine has been rapidly adopted
This study focused on the question of whether care could be efficiently initiated if the initial visit with a provider occurred via telemedicine
Overview This was a retrospective cohort study of patients with thoracic malignancies seen by a multidisciplinary team at the University of Pennsylvania Health System (UPHS) over four months encompassing the time period immediately preceding and including the first surge of COVID-19 cases in Philadelphia (March 1 to June 30, 2020)
Summary
To ensure safe delivery of oncologic care during the COVID-19 pandemic, telemedicine has been rapidly adopted. Little data exist on the impact of telemedicine on quality and accessibility of oncologic care. This study assessed whether conducting an office visit for thoracic oncology patients via telemedicine affected time to treatment initiation and accessibility. Patients with thoracic malignancies have an especially high risk of mortality following infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), potentially due to underlying structural lung disease and treatments used in this type of malignancy [1]. Physicians have had to balance the competing risks of SARS-CoV-2 exposure through clinic visits and the danger of delayed treatment [2]. Guidelines have been established for the timely initiation of treatment following diagnosis [4,5,6]. It has previously been observed that there can be considerable variation in time to treatment initiation between and within health systems [7, 8] with additional impacts on patient dissatisfaction and distress [9]
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