Impact of Telemedicine on Healthcare Delivery in Gastrointestinal Cancer Patients during the COVID-19 Pandemic.

Abstract

COVID-19 pandemic necessitated to change the normal OPD practices in view of lockdown and to decrease the exposure of patients and health care workers. Hence our institute adopted the telemedicine route to cater to the needs and grievances of patients. In this article we have analysed the impact of telemedicine on gastrointestinal cancer patients in Radiotherapy and Oncology OPD during COVID-19 pandemic. Retrospective data was extracted from the files of the patients who were seen through telemedicine. Time period for this study was kept from 1st September 2020 to 31st October 2020. Patients with only gastrointestinal malignancies were enrolled in the study. Patients were called telephonically to get their feedback on the telemedicine experience. Every patient completed a set of questionnaires. Physical OPDs were also running simultaneously with appointments made through telemedicine to reduce crowding and maintain social distancing. In total, data of 157 patients was obtained. Sixty three percent of the patients were from rural background while 37% had urban residence. Median age of the patients was 55 years (range,13-80years). Thirty eight percent patients had stage IV,51.6% had stage III while 8.9% had early-stage malignancies. Sixty percent of the patients had either received or were on radical treatment while 39.5% were taking palliative treatment. Approximately 53% of OPD visits could be avoided with telemedicine. Overall, the experience of telemedicine received an encouraging response with 87.3% of patients responding affirmatively to repeat the telemedicine if given opportunity. Telemedicine has led to un-interrupted delivery of cancer care, particularly for patients who were on active surveillance and live at remote places from the hospital. Our study demonstrated patient and healthcare staff safety along with the benefits of health care facilities to patients during this period of pandemic, though assessment of long-term impact on patient outcomes and health care systems needs to be done.