Telehealth visit type and patient-reported outcomes among patients with cancer

• Published in: Urologic oncology 2024-12, Vol.42 (12), p.448.e17-448.e22
• Main Authors: Carson, Daniel S., Simpson, Sam, Gadzinski, Adam J., Holt, Sarah K., Stewart, Blair, Wolff, Erika M., Ellimoottil, Chad, Gore, John L.
• Format: Article
• Language: English
• Subjects: Access to care; Adult; Aged; COVID-19; COVID-19 - economics; COVID-19 - epidemiology; Female; Healthcare legislation; Humans; Male; Middle Aged; Patient Reported Outcome Measures; Patient Satisfaction - statistics & numerical data; Public health; SARS-CoV-2; Telehealth; Telemedicine - economics; Telemedicine - statistics & numerical data; Urologic cancer; Urologic Neoplasms - economics; Urologic Neoplasms - therapy
• ISSN: 1078-1439; 1873-2496; 1873-2496
• DOI: 10.1016/j.urolonc.2024.07.015

•Telehealth received high patient satisfaction scores for new and established visits for urologic cancer.•Telehealth visits, both new and established, demonstrated markedly lower cost and travel burden for patients compared to in-person visits.•More telehealth patients felt physical exams were not necessary at every visit.•Expiration of COVID-19 emergency licensure waivers currently limits availability of telehealth use for new visits in some states. Relaxed licensing restrictions on telehealth use during the COVID-19 pandemic allowed broad use irrespective of visit type. As these telehealth waivers expire, optimal uses of telehealth must be assessed to inform policy and clinical care. We evaluated patient experience associated with telehealth and in-person new or established visits. Patients seen in-person and via telehealth for urologic cancer care from August 2019 to June 2022 received a survey on satisfaction with care, perceptions of communication during their visit, travel time, travel costs, and days of work missed. We assessed survey responses with descriptive statistics. Surveys were completed for 1,031 patient visits (N = 494 new visits, N = 537 established visits). Satisfaction rates were high for all visit modalities among new and established patients (mean score range 59.9–60.7 [maximum 63], P > 0.05). Patient-rated quality of the encounter did not differ by visit type and modality (P > 0.05, for nearly all comparisons). New in-person patient visits were associated with significantly higher travel costs (mean $496.10, SD $1021) compared with new telehealth visits (mean $26.60, SD $141; P < 0.001); 27% of new in-person patients required plane travel and 41% required a hotel stay (P < 0.001 vs. 0.8% and 3.2% of new telehealth patients, respectively). Satisfaction outcomes among patients with urologic cancer receiving new patient telehealth care equaled those of new patients cared for in-person while costs were significantly lower. Offering telehealth exemption beyond COVID-19 licensing waivers to include new patient visits would allow for ongoing delivery of high-quality urologic cancer care irrespective of geographic location.