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

Abstract

Purpose: Telemedicine was rapidly and ubiquitously adopted during the COVID-19 pandemic. However, there are growing discussions as to its role postpandemic. Methods and Materials: We surveyed patients, radiation oncology (RO) attendings, and RO residents to assess their experience with telemedicine. Surveys addressed quality of patient care and utility of telemedicine for teaching and learning core competencies. Satisfaction was rated on a 6-point Likert-type scale. The quality of teaching and learning was graded on a 5point Likert-type scale, with overall scores calculated by the average rating of each core competency required by the Accreditation Council for Graduate Medical Education (range, 1-5). Results: Responses were collected from 56 patients, 12 RO attendings, and 13 RO residents. Patient feedback was collected at 17 new-patient, 22 on-treatment, and 17 follow-up video visits. Overall, 88% of patients were satisfied with virtual visits. A lower proportion of on-treatment patients rated their virtual visit as "very satisfactory" (68.2% vs 76.5% for new patients and 82.4% for follow-ups). Only 5.9% of the new patients and none of the follow-up patients were dissatisfied, and 27% of on-treatment patients were dissatisfied. The large majority of patients (88%) indicated that they would continue to use virtual visits as long as a physical examination was not needed. Overall scores for medical training were 4.1 out of 5 (range, 2.8-5.0) by RO residents and 3.2 (range, 2.0-4.0) by RO attendings. All residents and 92% of attendings indicated they would use telemedicine again; however, most indicated that telemedicine is best for follow-up visits. Conclusions: Telemedicine is a convenient means of delivering care to patients, with some limitations demonstrated for on-treatment patients. The majority of both patients and providers are interested in using telemedicine again, and it will likely continue to supplement patient care.

Physicians’ Perceptions on the Role of Telemedicine in Cancer Care During and Post-COVID-19 Pandemic

“…It is interesting to note that majority of study respondents use telemedicine for follow-up consults, and less of them prefer to use if for first consults. This implies that some respondents preferred conducting initial consults face-toface.This is similar to the study by Gutkin 27 where majority of telemedicine users expressed that telemedicine is best suited for follow-up visits. First consults are usually lengthier than follow-up consults, and it may be prudent to consider telemedicine for first consults to conduct history-taking and screen patients and reserve face-to-face consults for followup visits where a shorter, more targeted examination of the patient can be done.…”

The New Normal? Patient Satisfaction and Usability of Telemedicine in Breast Cancer Care

“…However, recent studies have assessed patient satisfaction across all cancer types or within a specific oncologic subspecialty such as radiation oncology, and in many cases have done so without using a validated survey tool. [27][28][29][30] Our study was unique in that it assessed satisfaction and usability specifically within the breast cancer population across all oncologic subspecialties using an adapted version of the TUQ, which consists of questions compiled FIG. 2 Patient satisfaction scores on a 7-point Likert scale by status of breast cancer treatment (n = 75).…”

“…However, recent studies have assessed patient satisfaction across all cancer types or within a specific oncologic subspecialty such as radiation oncology, and in many cases have done so without using a validated survey tool. 27 – 30 …”

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“…In doing so, it is typically billed at a lower cost than inperson visits and allows to provide affordable healthcare services for more people to access. 7 Moreover, patients using telemedicine do not need to travel to medical centers, take time off work, or spend time waiting for providers. 4 Therefore, remote care and diagnosis offered by telemedicine can benefit patients and healthcare systems with the reduction of travel costs for specialist care and the associated time and stress when compared to the case of in-person visits.…”

“…As a result, telemedicine has been rapidly adopted to evaluate and treat patients. 4,7,8 Telemedicine is a major driver in shifting the healthcare delivery model.…”