No abstract

possibility, 4 did not feel confident and 3 did not have the correct equipment. The remaining patients cited numerous reasons for not taking up this service. In the satisfaction analysis of 17 initial telemedicine consultations 5/6 patients (81%) were very satisfied with telemedicine follow up. 4 patients (66%) found the platform extremely easy and 2 (34%) easy to use. Conclusion: On treatment monitoring of oral TKI therapy could be effectively carried out using video consultation platform reducing the number of hospital visits. The consultations provided necessary information and allowed for adequate clinical assessment. However the initial take up rate is low mostly due to patient reluctance rather than unavailable technology. The overall feedback from participants was very positive and accepting of the service. The iKonsult video consultation is being introduced into other oncology settings.Background: 50+% of cancer-related toxicities are under-reported. A real-time Remote (i.e., at-home) Symptom Reporting (RSR) system could help patients seek help when symptoms exceed thresholds, mitigating unplanned clinic/emergency room visits. A RSR system for solid-tumor patients undergoing chemotherapy is associated with improved health-related quality of life and survival (Basch et al, 2017). Adapting RSR into the thoracic cancer clinic environment requires assessments of potential implementation barriers, and tailoring of the RSR-system. Method: Over a five month period, we performed an environmental scan to determine readiness of RSR implementation in our comprehensive thoracic oncology outpatient clinic. A qualitative assessment of potential RSR integration into the telephone triage environment was performed through one-on-one interviews and focus groups, followed by thematic analysis. Discussions were held with multiple stakeholders; key implementation champions were identified. We utilized the Canadian Institutes of Health Research Knowledge-to-Action Framework, Steps 2-4 as our guide. Result: In the environmental scan, 125 telephone triage calls were logged over randomlychosen days in a 6-week period. The mean ± SEM call duration was 5.4 ± 0.62 minutes. Mean time until response was 44.4 ± 3.8 minutes. Nurses spent on average 2.7 ± 0.2 minutes documenting into the electronic-patient-record. The mean duration from initial contact to completion was 24.1 ± 4.5 minutes. Resolution of the triage calls involved telephone advice alone (87%; n¼109), unplanned clinic visits (6%; n¼8), and emergency visits (6%; n¼7). In the qualitative analyses, top stakeholder-identified issues were: lack of assessment standardization; wasted time transcribing paper triage notes to electronic records; and a high patient/family burden in terms on understanding when to seek help. There was universal interest in adopting a RSR system from administrative assistants, nursing administration, clinic nurses, physicians and trainees. Perceived benefits of RSR were: standardized, focused telephone assessments; tailored symptom assessments in the tho...

No abstract