Telemedicine patient satisfaction metrics and methods of recurrence detection for gynecologic cancer patients throughout the initial year of the COVID-19 pandemic (515)

Abstract

Objectives: To determine the patient satisfaction with telemedicine services throughout the initial year of the COVID-19 pandemic and evaluate detection of recurrence in those patients at a single, academic, tertiary-care medical center.Methods: Our Gynecologic Oncology clinic schedule was queried for all telemedicine encounters during the period of April 27, 2020- March 30, 2021. To assess patient satisfaction with telemedicine encounters, a modified 12-item Telemedicine Satisfaction Survey (TeSS) was administered to patients. Up to three contact attempts by phone were made for each patient. The exclusion criteria included patients requiring interpreter services. To analyze the initial method of diagnosis of recurrent gynecologic cancer during the COVID-19 pandemic, a retrospective chart review was completed on patients reached for survey completion.Results: Three hundred ninety-four patients were contacted. Three hundred sixteen completed the survey, and 78 declined, with a survey response rate of 80.2% (316/394). The mean age at cancer diagnosis was 60.1 years. The mean distance traveled from a patient’s home to the Gynecologic Oncology clinic was 50.4 miles. As detailed in Figure 1, personal comfort using telemedicine was rated as good or excellent by 90.8% of patients (n = 287). Almost 93.7% of patients felt that the explanation of treatment by the telemedicine staff was good or excellent (n=296). The courtesy, respect, sensitivity, and friendliness of staff during the telemedicine encounter was rated as excellent by 80.7% of patients (n=255). Of the 394 patients, 312 had pathologically-proven gynecologic malignancies. Of these patients, 9.3% (29/312) had recurrent gynecologic cancer during the study period. The initial method of recurrence detection included patient-reported symptoms (62.1%, n=18), routine biomarker (24.1%, n=7), and routine imaging (13.8%, n=4). Of the 364 patients, 72.6% used telemedicine for surveillance, 26.1% for postoperative visits, 11.7% for chemotherapy, 3.6% for problem visits, 1.3% for preoperative visits, and 0.5% for initial visits. Ultimately, 92.7% of patients rated their “overall treatment experience at using telehealth” as good or excellent (n=293). Telemedicine was well-received, with 87.0% of patients (n=275) indicating they would use telehealth again and 82.0% of patients (n=259) stating they would recommend telehealth to another gynecology oncology patient.Conclusions: With high patient acceptability, this study provides evidence to support the use of telemedicine as an option for gynecologic cancer surveillance in the post-pandemic period. Guided by patient health factors and preferences, telemedicine may be leveraged to reduce barriers to gynecologic specialty care such as distance traveled to the clinic while at the same time maximizing clinic capacity for patients necessitating in-person examination.