Pilot Study of Telehealth Evaluations in Patients Undergoing Hematopoietic Cell Transplantation

Abstract

Telehealth involves the use of telecommunication and information technology for the delivery of clinical care and may be a mechanism to alleviate the burden of visits faced by patients undergoing hematopoietic cell transplantation (HCT). Few studies have evaluated the feasibility and acceptability of telehealth visits in the care of HCT patients. We conducted 27 telehealth visits with 25 patients undergoing HCT using a videoconferencing system that allows for realtime, 2-way interactions and administered satisfaction surveys to patients and providers. Of the 25 patients included in the study, 20 (80%) and 5 (20%) were undergoing autologous and allogeneic HCT, respectively. The telehealth visits were distributed as follows: 3 inpatient visits upon admission for HCT; 11 inpatient visits between 2 and 14 days post-HCT; 4 inpatient visits prior to discharge after HCT; 8 outpatient, post-HCT follow-up visits; and 1 handoff to a community oncologist. Out of a total of 54 provider assessments, 7 providers (13%) were unable to complete some part of the physical examination, but no provider reported being unable to manage patients' symptoms through telehealth. Eighty-one percent of patients were either satisfied or very satisfied with the telemedicine session. Overall satisfaction was higher among patients than providers (mean scores 4.12 versus 2.64; scale 1 to 5, with 1 = very poor to 5 = excellent). Technological barriers resulting in delays and suboptimal physical examination were largely responsible for provider dissatisfaction. The use of telehealth to deliver comprehensive follow-up care to HCT patients is feasible across different HCT types but is dependent upon quality of data streaming and videoconferencing technologies.

Use of Telehealth for Domiciliary Follow-up After Hematopoietic Cell Transplantation During the COVID-19 Pandemic: Prospective Pilot Study

“…Our prospective study showed that the use of mobile health care devices and smartphone apps for self-reported outcomes is feasible in the post-HCT setting. In a study conducted by Nawas et al [ 6 ], it was found that telehealth evaluations could be useful in the early peritransplant period, with a high satisfaction rate among patients. In our study, we found that patients felt safer when using the telehealth system.…”

“…Finally, the quality of telehealth monitoring should be complemented and improved by the collection of other clinically relevant parameters. For example, a virtual physical examination could be carried out through the use of high-quality video calls, digital stethoscopes, and weight scales [ 6 , 7 ]. In our study, the system worked well for detecting acute complications such as infections and dehydration.…”

A Thematic Analysis of Provider Comparisons of Telemedicine Satisfaction Measures

“…This often leads to cases where researchers are defining new measures for specific studies or merging and modifying items from previous questionnaires [20]. In other cases, researchers are relying on single measures of overall satisfaction that do not consider other possible dimensions of the construct [10,21]. This creates a state in telemedicine research where evaluations and comparisons of studies and measures may be difficult.…”

Content Validity and Telemedicine Satisfaction Measures

“…Still concerns are often raised about the lack of attention to the multidimensionality of satisfaction in the telemedicine literature [19]. Yet even recent telemedicine studies still often rely on single measures of overall satisfaction [20]. Although, overall satisfaction may be a good enough indicator for these studies, it is important to consider what is being evaluated and whether measures fit their suggested meaning.…”