Patient Impressions of Telemedicine in Radiation Oncology

Abstract

The increasing use of telemedicine in radiation oncology (RO) since the start of the COVID-19 pandemic highlights the need to understand its role in routine practice. The objective of this study was to assess patient satisfaction with telemedicine in radiation oncology. Secondary objectives included understanding patient motivations for using telemedicine, quantifying the value of telemedicine as an option for care delivery, and characterizing preferences regarding how it should be utilized in their care. We surveyed patients at our institution about their experience with telemedicine video visits (VVs) in the RO department. Patients were eligible for inclusion if they were English-speaking and participated in a VV with our RO department after January 2020. A convenience sample was obtained, with preference for enrolling patients who completed a VV within 6 months of survey administration (rolling) and for patients treated for a diversity of cancer types. Surveys were administered from August 2021 to October 2022. A total of 155 patients were approached to complete the survey. Interested patients were emailed a link to a consent form and survey, and 25 patients (16%) completed both. The study closed early due to lack of funding for staff to approach and enroll patients. 96% of patients reported being satisfied with their telemedicine experience in RO and 92% would prefer to have the option of VVs after the resolution of the COVID-19 pandemic. Regarding visit type, 50% of patients preferred in-person visits over VVs for initial consults, while 68% and 77% preferred VVs for weekly on-treatment-visits and follow-up visits, respectively. All patients agreed that their health issues could be adequately addressed with VVs, but only 80% felt that their issues could be addressed with a phone call or email message. The most reported reason for preferring VVs was reduced travel burden. 60% of patients stated they would be more likely to seek cancer treatment at a facility offering VVs and 52% would pay more for a VV than an in-person visit. 92% of patients felt their connection with their physician was as strong as or stronger with VVs than with in-person visits, and 96% trusted their physician to determine when a VV would be medically appropriate. Surveyed patients were satisfied with VVs in RO at our institution, consistent with reports published by our group and others suggesting high rates of satisfaction with VVs by both providers and patients. Our data also suggest that patients find VVs convenient and even prefer them to in-person visits in some cases, without an impact on their perceived ability to have their medical issues addressed or a degradation of their relationship with their physician. The availability of telemedicine options may influence where some patients seek care and their willingness to pay. This study supports the need for ongoing reimbursement for VVs to ensure that patients continue to have access to their cancer care teams.