Telemedicine: A new survivorship visit model.

Abstract

89 Background: The number of cancer survivors in the United States is expected to approach 22 million by the year 2029. With an annual Survivorship Program visit volume exceeding 16,000, this comprehensive cancer center developed an innovative approach to delivering survivorship care to meet the growing demand for comprehensive follow up care. Institutional space, patient convenience and visit compliance are also factors in considering alternatives to traditional ‘brick and mortar’ visits. Methods: Patients are seen in our Autologous Bone Marrow Transplant (BMT) Survivorship Clinic at 6, 12- and 24-months post-transplant. A pilot was developed targeting patients scheduled for a 6-month visit, where patients are often struggling with treatment sequelae, managing other medical appointments, and returning to work and life after transplant. Patients were offered a telemedicine visit instead of an in-person clinic visit with the survivorship advanced practice provider (APP). The Survivorship APP and administrative staff were trained on the use of monitors and technologic means to connect patient to provider. Eligible patients had to have an institutional portal account and speak English. They were contacted by phone to assess interest, and if they agreed, instructions were provided via secure institutional portal reviewing device and connectivity requirements. Results: The telemedicine visit components included: review of home medication list, interval history and review of systems, screen for late treatment effects, lab result review, treatment summary and care plan review including risk of secondary cancer and screening recommendations, health promotion counseling, primary care physician recommendations and immunization status. Of 26 visits scheduled, 22 were successfully completed. Challenges to completing the visit will be described and include poor connectivity and patient location at the time of the scheduled visit. Conclusions: Despite some minor challenges, patients described good satisfaction with telemedicine citing visit comprehensiveness and convenience. As a result of the successful pilot, telemedicine visits are being expanded to include survivorship patients who are 24 months post BMT.