Perceptions of telehealth in real‐world oncological care: An exploration of matched patient‐ and clinician‐reported acceptability data from an Australian cancer centre

Abstract

Background Prior to 2020, the use of telehealth in cancer care was limited, but COVID‐19 necessitated its rapid and widespread adoption into routine care delivery. This study aimed to evaluate perceptions of telehealth through a dyadic exploration of matched cancer patient‐ and clinician‐reported acceptability data and to explore factors that may predict greater suitability for telehealth. Methods A prospective, cross‐sectional, exploratory survey study assessed (matched) patient‐ and clinician‐reported perceptions of telehealth consultations occurring at a metropolitan, tertiary‐based cancer centre in Victoria, Australia. Results One‐hundred and fifty‐five matched patient‐ and clinician‐reported data were included. High rates of acceptability with telehealth were reported by patients (93%) and clinicians (91%), who mostly shared concordant views (86%). Factors significantly associated with increased acceptability for telehealth, included, for clinicians, greater familiarity with the patient (OR 8.20, 95% CI: 1.50–45.06, p = 0.02), and younger patient age (OR 1.06, 95% CI: 0.99–1.13, p = 0.05), and for patients was earlier stage disease (≤stage III) (OR 5.29, 95% CI: 1.08–25.82, p = 0.04). Lower acceptability for telehealth according to clinicians was associated with poorer patient performance status (OR 0.04, 95% CI 1.00–1.08, p = 0.04) and for patients with the need for an interpreter (0R 0.06, 95% CI: 0.008–0.51, p = 0.009). Conclusion While overall telehealth is acceptable in cancer care, our findings raise important implications for future service development, notably that it may be less optimal for patients with higher complexity of need—including those with more advanced disease, poorer performance status, those less well known to treating clinicians and those identified to have additional language barriers.

Virtual Cancer Care Beyond the COVID-19 Pandemic: Patient and Staff Perspectives and Recommendations

“…Similar to findings in other settings, [34][35][36][37] In concordance with previous reports, [37][38][39] our findings suggest that age, sex, education, language, and confidence with internet use were associated with virtual care preferences, patients from racialized groups felt that virtual care reinforced racial bias in the care that they received, and accessibility remains a major barrier for some patients. Partnership with patient and caregiver advisors to understand how to best address issues of health inequities, bias, and accessibility and when developing virtual care policy and adopting technology is needed (Table 4).…”

“…Similar to findings in other settings, 34-37 while overall satisfaction was high, a greater proportion of patients reported satisfaction with virtual care than physicians (80.1% v 53.4%; P < .01). In addition, fewer patients than physicians felt that virtual visits were worse than those conducted in person (28.0 v 43.4%; P < .01) and that telephone and video visits negatively affected the human interaction that they valued (59.8% v 82.0%; P < .01).…”

Changes in rural caregivers' health behaviors while supporting someone with cancer: A qualitative study

“…Our findings suggest that minimizing the need to travel for treatment is a priority for supporting the health and wellbeing of rural caregivers. This could be achieved by coordinating appointments between healthcare professionals in metropolitan‐based centers or providing follow‐up via telehealth where possible 46 …”

“…This could be achieved by coordinating appointments between healthcare professionals in metropolitan-based centers or providing follow-up via telehealth where possible. 46 At the policy level, further work is needed to improve accessibility to welfare support for carers, including prompt eligibility assessments and payments. This need has been expressed by rural caregivers in other studies, 47 and our findings suggest that improving access to welfare support may benefit rural caregivers' diet, social connection and leisure, and use of health care services when needed.…”

Latent profiles of telehealth care satisfaction during the COVID-19 pandemic among patients with cardiac conditions in an outpatient setting

“… 10 , 11 , 12 In addition, patients’ medical profile (eg, type of disease and disease severity) may also affect their telehealth preferences. 13 These findings indicate that a personalized approach toward the implementation of remote care might be warranted. However, more research is needed to establish an evidence base.…”