Teleoncology: A Solution for Everyone? A Single-Center Experience with Telemedicine during the Coronavirus Disease 2019 (COVID-19) Pandemic

Abstract

Since the beginning of the COVID-19 pandemic, the use of telehealth was rapidly implemented without previous evidence. The ONCOTELEMD study aimed to evaluate the opinion of patients attended via telemedicine during this period and to study factors that condition patient preferences on its use. Included patients had a confirmed cancer diagnosis and were contacted by telephone between 13 March and 30 April 2020, in the Medical Oncology Service of Hospital Parc Taulí, Sabadell. A 12-question survey was presented to them between 4 February and 19 April 2021. Statistical analysis was carried out using chi-square and multivariable logistic regression tests. Six hundred forty-six patients were included; 487 responded to the survey. The median age was 68 years (27–90), 55.2% were female. Most patients had a surveillance visit (65.3%) and were diagnosed with colorectal or breast cancer (43% and 26.5%, respectively); 91.8% of patients were satisfied, and 60% would accept the use of telemedicine beyond the pandemic. Patients aged more than 50 years (OR 0.40; 95% CI, 0.19–0.81; p = 0.01) and diagnosed with breast cancer (OR 0.45; 95% CI, 0.26–0.69; p < 0.001) were less predisposed to adopt telehealth in the future. Patients agreed to be informed via telehealth of scan or lab results (62% and 84%, respectively) but not of new oral or endovenous treatments (52% and 33.5%, respectively). Additionally, 75% of patients had a medium or low-null technologic ability, and 51.3% would only use the telephone or video call to contact health professionals. However, differences were found according to age groups (p < 0.0001). In total, patients surveyed were satisfied with telemedicine and believed telehealth could have a role following the COVID-19 pandemic. Moreover, our results remark on the importance of individualizing the use of telehealth, showing relevant data on patient preferences and digital literacy.

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

“…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.…”

“…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.…”

Telemedicine in geriatric oncology – lessons learned from the COVID-19 experience

“…Telemedicine is recognized by American Society of Clinical Oncology (ASCO) as a safer mode of care to cancer patients caused by suppressed immune systems and to increase access to healthcare services for patients in rural communities [8]. If feasible, ASCO and the European Society of Medical Oncology advised the use of telemedicine to decrease the risk of infection [9]. Other organizations including the World Health Organization, Centers for Medicare and Medicaid Services, and the European Centre for Disease Prevention and Control also supported using telemedicine to reduce the risk of COVID-19 and provide access to healthcare [10].…”

“…Older patients preferred telephone only (47.6%) and reported low or null levels of technological knowledge. In the same study patients with breast cancer and >50 years of age were less inclined to change to telemedicine [9]. It is important to identify patient challenges to use telemedicine services and provide alternative formats or prioritize in-person visits.…”