The Utility and Impact of Telemedicine in Childhood Cancer Care: A Mixed Methods Study

Background: While teleconsultation has proven feasible for adult cancer patients, its utility in childhood cancer care in India is unknown. This study assesses caregiver satisfaction, feasibility, and the economic impact of teleconsultation for children with cancer.

Procedure: This mixed methods study was conducted in the pediatric cancer outpatient service at a tertiary care cancer center in India. Routine care teleconsultations were performed via telephone or email. Caregivers who received teleconsultations during the study period or 6 months prior were interviewed by phone. Data collected included demographic details, teleconsultation usage patterns, caregiver satisfaction, reasons for satisfaction or dissatisfaction, and cost savings. Logistic regression identified baseline characteristics associated with satisfaction. In-depth interviews were conducted in a separate cohort till thematic saturation.

Results: Caregivers of 465 children were included for telephonic and eight for in-depth interviews Among the respondents, 72.8% (n = 339) were satisfied with teleconsultation, and 85.4% (n = 397) of those planned to continue using it. Significant reasons for satisfaction were cost and time savings, while difficulty explaining issues caused dissatisfaction. Multivariable analysis showed parental education above high school [OR: 1.59, p = 0.035] increased satisfaction likelihood, while a residential distance of greater than 100 km from the hospital [OR: 0.62, p = 0.033] decreased it. Median cost savings per visit was $24.2 (range: $1-$846). Cost savings did not determine satisfaction magnitude. Frequently cited themes included cost and time savings and the need for literacy to benefit from teleconsultation.

Conclusions: Teleconsultation is feasible and effective for routine childhood cancer care, even in resource-constrained settings.