Patterns of virtual care among long-term cancer survivors.

Abstract

335 Background: The recent pandemic led to an untypical demand for virtual care visits in our comprehensive cancer center. Our institution responded to this paradigm shift by offering virtual care to all cancer patients, including cancer survivors. In place of an in-person visit, patients were offered a live video or telephone (audio) appointment for their survivorship clinic visit. We conducted a quality improvement study to identify patterns in the type of virtual visits preferred by patients scheduled for appointments in eight dedicated survivorship clinics. Methods: We conducted a retrospective review of 4784 patients’ medical records who were seen in eight site-specific survivorship clinics from April 2020 – April 2021. Variables reviewed included type of visit, i.e. telephone, live video, or in-person, and patient characteristics such as age, gender, clinic, and distance from cancer center. Descriptive statistics were performed to assess for patterns of virtual care. The review was approved by the Quality Improvement Assessment Board. Results: Virtual care visits varied by clinic (0-86%). Five clinics ((breast, lymphoma, sarcoma, melanoma, and gynecological) performed < 3% of visits using virtual format. A sub-analysis of the 8 clinics performing virtual visits demonstrates 59.5% virtual activity (19.23% phone compared to 39.3% video). Older patients were more likely to use any form of virtual visit compared to in-person (58.9% for those ≥ 65 vs. 54.9% for 18-39). Older patients were more likely to prefer phone visits (25.5% for ≥ 65 vs. 11.2% for 18-39). Local patients were more likely to utilize virtual visits (63% for patients < 75 miles vs. 45% for patients > 500 miles). Patients who lived furthest from the cancer center were more likely to travel in for their appointment, though this population contained fewer patients than those within 75 miles. Use of virtual visits for survivorship care varied, depending on the types of clinical diagnostic tests or examinations required for an annual visit. Conclusions: Our results indicate the use of virtual care was optimal when only lab testing was ordered by their provider. Older adults, with no or limited access to and knowledge of digital technology (computers, smartphones, and others similar tools) may need additional support to engage in video visits. Our findings suggest virtual care can be successfully implemented in the care of survivors. Further research would help determine best-practice approaches to facilitating patient engagement in virtual visits since telemedicine continues to evolve as a standard method to deliver safe and optimal cancer care.