Patients With Cancer Prefer Telemedicine to In-Person Visits; Satisfaction Is the Same

Although a slightly higher percentage of patients with cancer prefer telemedicine to in-person visits, satisfaction scores were equally high for both, according to a study from Memorial Sloan Kettering (MSK) Cancer Center researchers. The findings were published in JNCCN—Journal of the National Comprehensive Cancer Network.

The researchers assessed satisfaction and preference from 1,077 survey responses from radiation oncology patients. The patients received care at MSK’s main campus and six regional locations in New York and New Jersey. They were evaluating office and telemedicine visits that took place between December 2019 and June 2020.

A total of 726 of the patients were seen in office for prepandemic visit and 351 patients had telemedicine visits during the pandemic. The median age of patients with telemedicine visits was 65 years (66 years for office visits).

Satisfaction was largely the same. For level of concern by the physician, 92% of patients with a telemedicine visit compared with 93% of patients in office selected the top score. Similarly, 94% chose the top score for telemedicine and 94% for in office when evaluating the friendliness of their physician.

When rating the quality of their physician’s explanations, there was a slight advantage to telemedicine with 91% of those patients selecting the top score compared with 84% of patients who had an in-office visit.

“These findings provide some evidence that there is a role for telemedicine beyond the COVID-19 pandemic and that it can be a particularly useful tool for certain patients—especially those who may have challenges coming on-site for an appointment,” co-lead author Narek Shaverdian, MD, MSK Department of Radiation Oncology, said in a statement. “Giving patients flexibility and options by being able to see them both in-person and through telemedicine can improve access to care.”

According to the survey results, 45% of patients preferred telemedicine, 34% preferred in-office visits, and 21% had no preference for their visit type. Patients who were married or had a partner and who had better performance status were more likely to prefer in-person office visits.

Patients who had a telemedicine visit that included video conferencing were more satisfied. In comparison, patients who had a telephone-only appointment were more likely to say they would benefit from an in-person visit. Shaverdian noted that voice-only encounters with new patients are particularly challenging and telemedicine is really a benefit for patients who have and can use video capabilities.

“Digital tools like telemedicine have the unfortunate potential consequence of paradoxically increasing disparities in access to care,” said co-lead author Erin F. Gillespie, MD, MSK Department of Radiation Oncology. “But the counter to that is there will be some disadvantaged patients that would not have accessed the system at all, either due to technologic barriers or travel time, and now can connect at least by phone, which is an important and positive change.”

While one-third (34%) of patients who completed the telemedicine survey agreed with the statement that “cancer care will be negatively impacted” by the COVID-19 pandemic, only 8% were concerned their own cancer would not be treated successfully because of the pandemic.

Delays in diagnosis and treatment of cancer have been well documented and are expected to cause tens to hundreds of thousands of excess cancer deaths. In 2020, screening and treatments for breast, colon, prostate, and lung cancers saw a particularly harsh decline, according to a study from Avalere Health and the Community Oncology Alliance.

“Telemedicine maintained patient confidence in the physician and treatment, but efforts to increase access to audiovisual technologies must be prioritized to improve patient– physician communication,” the authors concluded. “These data should help inform efforts to maintain access to telemedicine for patients with cancer beyond the pandemic, while highlighting the importance of equitable access to audiovisual technologies to support the most vulnerable patients.”