Exploring cancer patients’, caregivers’, and clinicians’ utilisation and experiences of telehealth services during COVID-19: A qualitative study

Smith, Sarah; Smith, Allan; Kennett, William; Vinod, Shalini

doi:10.1016/j.pec.2022.06.001

Cited by 17 publications

(13 citation statements)

References 49 publications

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“…While staff and providers offered important insights to the attitudes, challenges, needs, and feedback of their patients, we did not directly interview patients for this study. It is notable that studies such as that carried out by Smith et al [28] included patients and caregivers in their interviews and found similar themes to our work regarding the acceptability and efficiency of telehealth generally for cancer care, alongside concerns regarding the lack of physical exam. Further investigation and analysis of patient perceptions of telemedicine use in cancer care-especially as we transition to a postpandemic environment where more patients are familiar with telemedicine and novelty-should further extend understanding of the risks and benefits of telemedicine use in oncology settings to equitably serve the needs of diverse populations.…”

Section: Limitationssupporting

confidence: 79%

“…In a broader context, published studies of use trends of telehealth for cancer care suggest disparities in telehealth use, with patients in urban settings favoring telehealth more than rural [ 25 ], as well as other groups including older adults and patients of color [ 26 ]. Recent qualitative studies of telehealth for cancer care during the COVID-19 pandemic suggest that there is a subset of care situations within survivorship that is acceptable to providers and patients alike [ 27 ], and that telehealth has broadly been acceptable to many patients and providers even as concerns about a lack of physical exam are raised [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Adoption of Telemedicine in a Rural US Cancer Center Amid the COVID-19 Pandemic: Qualitative Study

Mackwood¹,

Butcher²,

Vaclavik³

et al. 2022

JMIR Cancer

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Background The COVID-19 pandemic necessitated a rapid shift to telemedicine to minimize patient and provider exposure risks. While telemedicine has been used in a variety of primary and specialty care settings for many years, it has been slow to be adopted in oncology care. Health care provider and administrator perspectives on factors affecting telemedicine use in oncology settings are not well understood, and the conditions associated with the COVID-19 pandemic offered the opportunity to study the adoption of telemedicine and the resulting provider and staff perspectives on its use. Objective The aim of this paper is to study the factors that influenced telemedicine uptake and sustained use in outpatient oncology clinics at a US cancer center to inform future telemedicine practices. Methods We used purposive sampling to recruit a mix of oncology specialty providers, practice managers, as well as nursing and administrative staff representing 5 outpatient oncology clinics affiliated with the Dartmouth Cancer Center, a large regional cancer center in the northeast of United States, to participate in semistructured interviews conducted over 6 weeks in spring 2021. The interview guide was informed by the 5 domains of the Consolidated Framework for Implementation Research, which include inner and outer setting factors, characteristics of the intervention (ie, telemedicine modality), individual-level factors (eg, provider and patient characteristics), and implementation processes. In total, 11 providers, 3 leaders, and 6 staff participated following verbal consent, and thematic saturation was reached across the full sample. We used a mixed deductive and inductive qualitative analysis approach to study the main influences on telemedicine uptake, implementation, and sustainability during the first year of the COVID-19 pandemic across the 5 settings. Results The predominant influencers of telemedicine adoption in this study were individual provider experiences and assumptions about patient preference and accessibility. Providers’ early telemedicine experiences, especially if negative, influenced preferences for telephone over video and affected sustained use. Telemedicine was most favorably viewed for lower-acuity cancer care, visits less dependent on physical exam, and for patient and caregiver education. A lack of clinical champions, leadership guidance, and vision hindered the implementation of standardized practices and were cited as essential for telemedicine sustainability. Respondents expressed anxiety about sustaining telemedicine use if reimbursements for telephonic visits diminished or ceased. Opportunities to enhance future efforts include a need to provide additional guidance supporting telemedicine use cases and evidence of effectiveness in oncology care and to address provider concerns with communication quality. Conclusions In a setting of decentralized care processes, early challenges in telemedicine implementation had an outsized impact on the nature and amount of sustained use. Proactively designed telemedicine care processes with attention to patient needs will be essential to support a sustained role for telemedicine in cancer care.

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Section: Limitationssupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Adoption of Telemedicine in a Rural US Cancer Center Amid the COVID-19 Pandemic: Qualitative Study

Mackwood¹,

Butcher²,

Vaclavik³

et al. 2022

JMIR Cancer

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“…In our study, clinicians perceived video to be more effective than telephone with the latter resulting in a loss of non-verbal communication and visual examination. 13 Oncologists and other health professionals have previously established that visual information is necessary for reading body language, visual cues and expressions during a consultation. [14][15][16][17] Whether it be collected indirectly during conversation, or directly as a tool for assessment, visualisation allows doctors to accurately understand the condition of their patient.…”

Section: Video Provides Non-verbal Communication and Visual Examinationmentioning

confidence: 99%

“…Similar to clinicians, we found that consumers have a preference to use video during consultations because video enables them to see and interact with their doctors, allowing rapport building and stronger doctor-patient communication. 13 Telephone is suitable for low-complexity consultations Although telephone was the least favourable method of telehealth amongst consumers and clinicians, telephone consultations were considered suitable for low-complexity consultations such as repeat prescriptions or providing test results that require no further discussion. Telephone calls regarding blood test results have previously been associated with positive telehealth experiences amongst patients.…”

Section: Video Provides Non-verbal Communication and Visual Examinationmentioning

confidence: 99%

Cancer care and management during COVID-19: A comparison of in-person, video and telephone consultations

et al. 2022

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In Australia, the COVID-19 pandemic has resulted in the exponential growth in the delivery of telehealth services. Medicare data indicates that the majority of telehealth consultations have used the telephone, despite the known benefits of using video. The aim of this study was to understand the perceived quality and effectiveness of in-person, telephone and videoconsultations for cancer care. Data was collected via online surveys with consumers ( n = 1162) and health professionals ( n = 59), followed by semi-structured interviews with telehealth experienced health professionals ( n = 22) and consumers ( n = 18). Data were analysed using descriptive statistics and significance was tested using the chi-square test. A framework analysis and thematic analysis were used for qualitative data. Results indicate telehealth is suitable for use across the cancer care pathway. However, consumers and health professionals perceived videoconsultations facilitated visual communication and improved patients’ quality of care. The telephone was appropriate for short transactional consultations such as repeat prescriptions. Consumers were rarely given the choice of consultation modality. The choice of modality depended on a range of factors such as the type of consultation and stage of cancer care. Hybrid models of care utilising in-person, video and telephone should be developed and requires further guidance to promote the adoption of telehealth in cancer care.

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“…The hospital must make quick repairs to complete the required claim documents/files based on the results of the initial BPJS Health verification through the E-Claim application. The submission for repair of pending claims is made at most 2 (two) times with a maximum period of 14 (fourteen) working days since the hospital receives information on pending/pending claims from BPJS Health (Smith et al, 2022). Mechanisms and settlement times for pending claims that have been completed and resubmitted by the hospital are like the initial mechanism again.…”

Section: Figure 1 Flow Of Claim Submissionmentioning

confidence: 99%

Claim Analysis of Cost Reimbursement COVID-19 Patient Service to Badan Penyelenggara Jaminan Sosial (BPJS) in health by Hospital

Sugiarto

Ilyas

2022

J. Sci. n.a

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The BPJS COVID-19 fee claim is the government's support in accelerating the handling of COVID-19 in Indonesia. BPJS Health data from January to October 2021, the submission of claims for COVID-19 reached 1,345,970 cases with a cost value of 72.3 trillion IDR. Of the claims submitted by the hospital, only 79.07% were following BPJS claim verification or equivalent to 64.1 trillion IDR. There are still 21% of COVID-19 cost claims that require clarification on dispute resolution. Therefore, it is necessary to study the COVID-19 cost claim according to the provisions and find out the obstacles that occur in submitting BPJS claims by hospitals. The method used is descriptive-analytic by using literature searches, reading materials, and scientific journals. The results obtained are that the claim for COVID-19 costs uses the provisions of the tariff per day/cost per day which is regulated in the technical instructions for claiming reimbursement of costs for COVID-19 patient services number HK.01.07/MENKES/5673/2021. The conclusion obtained is that there are still problems with COVID-19 cost claims in the administrative aspect, the limitations of the verifier team, and the integration of the claim submission system.

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Exploring cancer patients’, caregivers’, and clinicians’ utilisation and experiences of telehealth services during COVID-19: A qualitative study

Cited by 17 publications

References 49 publications

Adoption of Telemedicine in a Rural US Cancer Center Amid the COVID-19 Pandemic: Qualitative Study

Adoption of Telemedicine in a Rural US Cancer Center Amid the COVID-19 Pandemic: Qualitative Study

Cancer care and management during COVID-19: A comparison of in-person, video and telephone consultations

Claim Analysis of Cost Reimbursement COVID-19 Patient Service to Badan Penyelenggara Jaminan Sosial (BPJS) in health by Hospital

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