Patient and caregiver experience with telehealth for surgical cancer care: A qualitative study

Abstract

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).

Telehealth follow‐up consultations for melanoma patients during the COVID‐19 pandemic: Patient and clinician satisfaction

“…Clinicians and patients were congruent in expressing convenience, safety and improved access to care as benefits of telehealth, consistent with previously reported research 18,20,23,41 . Patients also reported that telehealth allowed family and friends to be present in a supportive role during the consultation, without a major impact on the family member/friend's routines.…”

“…This was echoed by the clinicians—most felt comfortable during telehealth consultations and believed that they delivered an adequate service, while still expressing a strong preference for face‐to‐face consultations. These views are consistent with those of other cancer patients 12 , 15 , 16 , 18 , 20 , 21 , 22 , 41 and their clinicians, 14 , 15 , 18 , 41 which suggests that telehealth cannot replace face‐to‐face consultations.…”

“…Organisational support is needed to invest in the most appropriate videoconferencing platforms, with suitable platforms already documented 13 . Virtual waiting rooms may be beneficial in communicating with patients when a clinician is late 20 . Closed captioning may be beneficial for people who are hard of hearing 48 .…”

“…19,41 Clinicians and patients were congruent in expressing convenience, safety and improved access to care as benefits of telehealth, consistent with previously reported research. 18,20,23,41 Patients also reported that telehealth allowed family and friends to be present in a supportive role during the consultation, without a major impact on the family member/friend's routines. This is in contrast with previous research in cancer patients, which identified that family and friends in supportive roles were less likely to attend telehealth appointment due to scheduling difficulties and patients not being aware of the opportunity.…”

“…inability to conduct physical examination, express empathy as easily, particularly when there is bad news and patient is distressed), there is a need to assess the satisfaction with this mode of service delivery. While patient and clinician satisfaction with telehealth has been described for other cancer types, 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 little is known about satisfaction with telehealth for follow‐up of melanoma patients. In melanoma context, where visual and physical examinations are a key feature of follow‐up consultations, telehealth may be perceived differently compared to other cancers.…”