Steel magnolias - shared telehealth for multidisciplinary gynecologic cancer survivorship: an innovative model for addressing geographic barriers to guideline adherent survivorship for rural patients (136)

Abstract

Objectives: Geographic disparities are linked to suboptimal cancer care. We aimed to describe our experience with our Shared TElEheaLth for MultidisciplinAry GyNecOLogIc cAncer Survivorship (SM) program with regards to financial toxicity, patient satisfaction, and travel burden. We also performed initial comparisons to rural patients who traveled to our clinic. Methods: After IRB approval, women in remission and on surveillance from gynecologic cancer living in a rural region with no practicing gynecologic oncologist were approached for enrollment after a clinic visit. After consent, the Patient Satisfaction Questionnaire Short Form 18 (PSQ-18) and the Comprehensive Score for Financial Toxicity- Functional Assessment of Chronic Illness Therapy (COST FACIT) questionnaires were administered. Women in the SM program were seen in person by a gynecologist close to home with a concomitant hospital-supplied tablet-based virtual visit by a gynecologic oncologist to address cancer-related survivorship issues. Others surveyed traveled (T) for surveillance to visit our gynecologic oncologists in person. Fisher’s exact tests were used for categorical comparisons and Wilcoxon Rank-Sum tests for continuous comparisons. Conclusions: We describe our initial experience with an innovative hybrid-virtual surveillance visit concept. Collaboration with the patients’ local gynecologists allowed for an in-person gynecology visit with an in tandem tablet-based gynecologic oncology session during the same visit. In this diverse, rural patient population, we demonstrated that this novel survivorship care delivery model resulted in fewer miles and shorter time traveled for patients. Financial toxicity was high overall. There were no early signals that financial toxicity or patient satisfaction was compromised. A considerable portion of the women we served reported a lack of access to amenities necessary for travel or self-guided telemedicine visits. We were able to overcome many of these transportation and technology barriers with the STEEL MAGNOLIAS program, ensuring more equitable delivery of gynecologic oncology care in the survivorship period. Objectives: Geographic disparities are linked to suboptimal cancer care. We aimed to describe our experience with our Shared TElEheaLth for MultidisciplinAry GyNecOLogIc cAncer Survivorship (SM) program with regards to financial toxicity, patient satisfaction, and travel burden. We also performed initial comparisons to rural patients who traveled to our clinic. Methods: After IRB approval, women in remission and on surveillance from gynecologic cancer living in a rural region with no practicing gynecologic oncologist were approached for enrollment after a clinic visit. After consent, the Patient Satisfaction Questionnaire Short Form 18 (PSQ-18) and the Comprehensive Score for Financial Toxicity- Functional Assessment of Chronic Illness Therapy (COST FACIT) questionnaires were administered. Women in the SM program were seen in person by a gynecologist close to home with a concomitant hospital-supplied tablet-based virtual visit by a gynecologic oncologist to address cancer-related survivorship issues. Others surveyed traveled (T) for surveillance to visit our gynecologic oncologists in person. Fisher’s exact tests were used for categorical comparisons and Wilcoxon Rank-Sum tests for continuous comparisons. Conclusions: We describe our initial experience with an innovative hybrid-virtual surveillance visit concept. Collaboration with the patients’ local gynecologists allowed for an in-person gynecology visit with an in tandem tablet-based gynecologic oncology session during the same visit. In this diverse, rural patient population, we demonstrated that this novel survivorship care delivery model resulted in fewer miles and shorter time traveled for patients. Financial toxicity was high overall. There were no early signals that financial toxicity or patient satisfaction was compromised. A considerable portion of the women we served reported a lack of access to amenities necessary for travel or self-guided telemedicine visits. We were able to overcome many of these transportation and technology barriers with the STEEL MAGNOLIAS program, ensuring more equitable delivery of gynecologic oncology care in the survivorship period.