Use of telemedicine consultations in head and neck cancer: patient perceptions, acceptability and accessibility

Abstract

Backgrounds: Telemedicine has been effective in the management of various medical conditions, however, there is limited knowledge of its use in head and neck oncosurveillance. This is of importance currently while trying to mitigate the risk of transmission during the COVID-19 pandemic. This study aims to evaluate acceptability, satisfaction and perceptions of telemedicine technology among outpatients for head and neck oncologic surveillance. Methods: A cross-sectional study was conducted for head and neck surgical oncology patients who attended telemedicine consultations between March and October 2020 at the Peter MacCallum Cancer Centre. Data on demographic, socioeconomic and acceptability variables was collected, utilizing Likert scale questions. The primary outcome measures were patient satisfaction and perceptions, while the secondary outcome was access to technology. Results: One hundred and fifteen patients were invited to participate, and 100 were included in the final analysis; 95% of patient's had a positive experience with telemedicine appointments and were willing to have future telemedicine appointments. Regional and rural patients were more accepting of telemedicine consultations, citing savings in travel time and the minimal disruption to normal day-to-day activities. All participants had access to telecommunication devices, with 63% having three or more devices. Issues identified include a lack of physical examination by clinician for 65% of participants and the inability to selfexamine for 88% of participants. Conclusion:The study demonstrates patients' acceptance of telemedicine appointments as a component of outpatient surveillance for head and neck surgical oncology. This has benefits during the COVID-19 pandemic in addition to increasing accessibility for rural patients.

The role of telehealth in the delivery of oral and maxillofacial surgery services at a level 6 hospital in New South Wales Australia during COVID-19 – the John Hunter Hospital experience: a commentary, review and cautionary tale for the future

“…Whilst it could be postulated that elective, low acuity Oral and Maxillofacial Surgery settings are adaptable to the Telemedicine setting, for the urgent patient, face-to-face appointments are important due to the sensitive nature of information to be delivered, especially in the initial appointment setting. Dhillon et al [6 ▪▪ ] noted in their cross-sectional study that 65% of Head and Neck cancer patients surveyed identified the lack of physical examination as an issue. Although several studies have shown high levels of satisfaction with Telehealth consults, there is limited evidence in relation to the factors affecting patient outcomes, for example, length of stay, complication rate or morbidity and mortality rates.…”

Survey of Danish Head and Neck Cancer Patients’ Positions on Personalized Medicine, Gene Tests, and Personalized Follow-Up

“…It would be interesting to explore our patients' positions on telemedicine (if all technical barriers such as computers and sufficient internet connection had been addressed). Following the COVID-19 pandemic, telemedicine has gained more interest, and studies from the United States, Australia, and the Netherlands have also proven that HNC patients are positive towards telemedicine as a part of the outpatient monitoring, but the lack of physical evaluation remains a limitation [33,34].…”

Recent advances in head and neck surgical oncology

“…This shift enables patients to conveniently discuss their concerns, receive updates, and obtain medical advice from the comfort of their homes. 75 Furthermore, the incorporation of highdefinition video technology has enabled meticulous visual examinations, affording healthcare providers the ability to assess surgical sites and monitor postoperative healing remotely. This technological innovation has yielded enhancements in diagnostic precision and contributed to a reduction in the requirement for physical examinations, as evidenced in a study that compared video-based free flap assessment following head and neck free tissue transfer to in-person evaluations.…”

“…Telemedicine platforms have empowered healthcare providers to conduct virtual consultations, thereby diminishing the necessity for in‐person visits. This shift enables patients to conveniently discuss their concerns, receive updates, and obtain medical advice from the comfort of their homes 75 . Furthermore, the incorporation of high‐definition video technology has enabled meticulous visual examinations, affording healthcare providers the ability to assess surgical sites and monitor postoperative healing remotely.…”