Experience of Telemedicine Visits in Radiation Oncology During the COVID-19 Pandemic: A US National Survey and Lessons Learned for Incorporating Telemedicine Post-COVID-19

Ting Martin Ma; Neil R Parikh; Rebecca G Philipson; Ritchell van Dams; Eric M Chang; John V Hegde; Amar U Kishan; Tania B Kaprealian; Michael L Steinberg; Ann C Raldow

doi:10.1016/j.adro.2022.100924

Experience of Telemedicine Visits in Radiation Oncology During the COVID-19 Pandemic: A US National Survey and Lessons Learned for Incorporating Telemedicine Post-COVID-19

Adv Radiat Oncol. 2023 Jan-Feb;8(1):100924. doi: 10.1016/j.adro.2022.100924. Epub 2022 Dec 12.

Affiliations

¹ Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California.
² San Antonio Cancer Center, San Antonio, Texas.
³ Department of Radiation Oncology, Torrance Memorial Medical Center, Torrance, California.
⁴ Department of Radiation Oncology, Dana Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts.
⁵ Department of Radiation Oncology, Oregon Health and Science University, Portland, Oregon.

Abstract

Purpose: We sought to survey the attitudes and perceptions of US radiation oncologists toward the adoption of telemedicine during the COVID-19 pandemic and offer suggestions for its integration in the postpandemic era.

Methods and materials: A 25-question, anonymous online survey was distributed nationwide to radiation oncologists.

Results: One hundred and twenty-one respondents completed the survey, with 92% from academia. Overall, 79% worked at institutions that had implemented a work-from-home policy, with which 74% were satisfied. Despite nearly all visit types being conducted in-person before COVID-19, 25%, 41%, and 5% of the respondents used telemedicine for more than half of their new consultations, follow-up, and on-treatment visits, respectively, during the COVID-19 pandemic. Most (83%) reported being comfortable integrating telemedicine. Although telemedicine was appreciated as being more convenient for patients (97%) and reducing transmission of infectious agents (83%), the most commonly perceived disadvantages were difficulty in performing physical examinations (90%), patients' inability to use technology adequately (74%), and technical malfunctions (72%). Compared with in-person visits, telemedicine was felt to be inferior in establishing a personal connection during consultation (90%) and assessing for toxicity while on-treatment (88%) and during follow-up (70%). For follow-up visits, genitourinary and thoracic were perceived as most appropriate for telemedicine while gynecologic and head and neck were considered the least appropriate. Overall, 70% were in favor of more telemedicine, even after pandemic is over.

Conclusions: Telemedicine will likely remain part of the radiation oncology workflow in most clinics after the pandemic. It should be used in conjunction with in-person visits, and may be best used for conducting follow-up visits in certain disease sites such as genitourinary and thoracic malignancies.