Introduction The COVID‐19 pandemic led to telemedicine adoption for many medical specialties, including surgical cancer care. To date, the evidence for patient experience of telemedicine among patients with cancer undergoing surgery is limited to quantitative surveys. Thus, this study qualitatively assessed the patient and caregiver experience of telehealth visits for surgical cancer care. Methods We conducted semistructured interviews with 25 patients with cancer and three caregivers who had completed a telehealth visit for preanesthesia or postoperative visits. Interviews covered visit descriptions, overall satisfaction, system experience, visit quality, what roles caregivers had, and thoughts on what types of surgery‐related visits would be appropriate through telehealth versus in‐person. Results Telehealth delivery for surgical cancer care was generally viewed positively. Multiple factors influenced the patient experience, including prior experience with telemedicine, ease of scheduling visits, smooth connection experiences, having access to technical support, high communication quality, and visit thoroughness. Participants identified use cases on telehealth for surgical cancer care, including postoperative visits for uncomplicated surgical procedures and educational visits. Conclusions Patient experiences with telehealth for surgical care are influenced by smooth system experiences, high‐quality patient‐clinician communications, and a patient‐centered focus. Interventions are needed to optimize telehealth delivery (e.g., improve telemedicine platform usability).

PURPOSE To address shortcomings of human scribes (eg, turnover), clinicians are considering digital scribes (DSs). To our knowledge, to date, no study has assessed DS implementation or clinician user experience in cancer centers. We assessed the DS's feasibility, acceptability, appropriateness, usability and its preliminary association on clinician well-being in a cancer center. We also identified implementation facilitators and barriers to DS use. METHODS Using a mixed-methods longitudinal pilot study design, we implemented a DS at a cancer center. Data collection included surveys at baseline and 1 month after DS use and a semistructured interview with clinicians. The survey assessed demographics, Mini Z (workplace stress and burnout), sleep quality, and implementation outcomes (feasibility, acceptability, appropriateness, and usability). The interview assessed how the DS was used and its impacts on workflows and recommendations for future implementations of the DS. We used paired t tests to assess differences in Mini Z and sleep quality measures over time. RESULTS Across nine survey responses and eight interviews, we found that although feasibility scores were slightly lower than our cutoff point (15.2 v 16.0), clinicians rated the DS as marginally acceptable (16.0) and appropriate (16.3). Usability was considered marginally usable (68.6 v 68.0). Although the DS did not significantly improve burnout (3.6 v 3.9, P = .081), it improved perceptions of having sufficient documentation time (2.1 v 3.6, P = .005). Clinicians identified suggestions for future implementations, including training needs and usability improvements. CONCLUSION Our preliminary findings suggest that DS implementation is marginally acceptable, appropriate, and usable among cancer care clinicians. Individualized training and on-site support may improve implementation.

Post-operative or adjuvant endocrine therapy (AET) is the mainstay of treatment for hormone receptor-positive (HR+) breast cancer. When taken daily for 5-to-10 years, AET improves the time to disease recurrence and overall survival rates. However, past work has shown that Black women are less likely to begin prescribed AET treatments and less likely to take these medications as directed, often discontinuing treatment early. For hormone receptor-positive (HR+) breast cancer, rates of death from breast cancer are higher than those of similar White women. This study investigates the patient-, provider-, and practice-level barriers to AET initiation and adherence faced by Black women with the ultimate goal of developing an intervention to address these barriers. This study consists of qualitative semi-structured interviews with two populations, Black breast cancer survivors with HR+ breast cancer who were prescribed AET and cancer care providers (including medical doctors and advance-practice providers). All participants were recruited from the same comprehensive cancer center with a dedicated breast cancer clinic. Data collection is ongoing; thus far, the sample includes fifteen interviews with breast cancer survivors and nine with providers. Participants were asked about the barriers to care they (or their patients) face, their (or their patients’) perception of AET, and their views of possible interventions to improve clinical practices related to AET initiation and adherence. Preliminary findings include differences in perceived barriers to care between Black women and their providers. Providers understood barriers to AET initiation and adherence as minimal compared to other treatments, in terms of cost, toxicity, and burden of care. Meanwhile, patients understood the cost of the treatment as very high, largely due to side-effect. While the price of the medications were not a common barrier, the side effects (including brain fog, bone aches, fatigue, and depression) impact patients’ interpersonal relationships, employment, and/or ability to perform care work for family members, were seen as a heavy burden. In addition, patient interviews showed a need for higher quality education regarding how AET therapy works and its importance in preventing recurrence. While providers described the myriad ways in which they educate their patients about AET and its importance in breast cancer care, patients interviewed described gaps in their knowledge related to how AET works and why it is an essential aspect of their care. These findings point to a need for reframing barriers to breast cancer care for providers and the implementation of new clinical procedures to address and rectify racial disparities in AET use. Citation Format: Hayden J. Fulton, Dannelle R. Charles, Kimberley T. Lee. Barriers to use of adjuvant endocrine therapy among Black women with breast cancer: A qualitative investigation [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B086.

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