Long-Term Institutional Experience With Telemedicine Services for Radiation Oncology: A Potential Model for Long-Term Utilization

Abstract

With the development of the coronavirus disease 2019 (COVID-19) pandemic, health care practices and radiation oncology departments have begun to incorporate telemedicine services to practice social distancing and minimize the chances of disease spread. Given the severity of this pandemic, it will likely fundamentally affect the use of these services for years to come. Our institution and radiation oncology department have used telemedicine services for many years; we would like to report on our departmental experience to guide other radiation oncology practices on its long-term use for clinical evaluation and patient care. Methods and Materials: Our institution's telemedicine program provides clinical services for a number of remote locations and represents the largest telehealth network in the world, with over 300 sites and 60,000 patient encounters a year. Results: Specifically for our radiation oncology department, over 200 patient encounters occur via telemedicine a year. Patients report great appreciation and satisfaction with these encounters, as they eliminate the time and energy needed for travel from long distances. It has resulted in improved efficiency and cost-effectiveness as well. Conclusions: Based on our institutional experience, our long-term vision for telemedicine (after COVID-19 pandemic has hopefully subsided) is as an excellent and cost-efficient tool to provide long-term follow-up for patients, especially for those who live far away in rural or underserved areas.

The Impact of COVID-19 on Cancer Screening: Challenges and Opportunities

“…Telemedicine, which literally means “healing at a distance” [ 120 ], could be understood as the delivery of health care services aiming to advance personal and population health [ 121 ]. Telemedicine allows timely, accessible, and cost-effective health care delivery to the patients, which renders itself a practical solution to COVID-19–induced constraints such as social distancing and self-isolation [ 122 - 124 ]. Telemedicine tools such as virtual reality devices have been found to be useful for training health care practitioners [ 125 ].…”

“Connection Failed”: A Word of Caution on Telemedicine in Radiation Oncology

“…Telemedicine consultations were viewed favorably due to their broad applicability, the reduced time and costs needed for follow-up, and increased convenience for patients with long travel distances. 16,17 However, these experiences included radiation oncology consultations for truly rural areas, with one survey being performed among patients a mean distance of 403 km from the hospital. 17 It is unclear how these experiences would translate to a broader application, as travel time and costs may be of lower priority for patients.…”

“…Telemedicine can be used to preselect patients who may benefit from in-person appointments, particularly in cancers where the role of physical examination for recurrence surveillance is limited. 16,17 However, studies will need to assess which patients are suitable for this approach and which patients will continue to benefit from regular inperson follow-up. As ROs, we treat many elderly patients, some of whom may not be familiar with telemedicine technologies or have difficulty using them.…”

Telemedicine in Radiation Oncology: Is It Here to Stay? Impacts on Patient Care and Resident Education

“…Telemedicine delivers secure virtual health care and has been selectively adopted over the past several years. 1 Virtual visits are particularly useful for patients who are immobile, live in remote locations, or are immunocompromised. Telemedicine is typically billed at a lower cost than in-person visits, offering accessible health care for disadvantaged populations.…”