medwireNews: Medical oncology healthcare professionals often have conflicting opinions regarding the clinical effectiveness, patient experience, access to care, and financial impact of using telehealth video consultations, US research shows.
Arianna Heyer (Sidney Kimmel Medical College, Philadelphia, Pennsylvania) and co-investigators say: “Understanding oncologists’ perceptions of telehealth elucidates potential barriers that need to be further investigated or improved for telehealth expansion and continued utilization.”
Writing in JAMA Network Open, the researchers note that, prior to the COVID-19 pandemic, use of telehealth by oncology specialists was limited despite its emergence as a way to improve access and reduce cost for medical oncology care.
They carried out their qualitative study between October 30 2019 and March 5 2020 using semistructured interviews that aimed to identify perceptions of the barriers to and benefits of telehealth video visits among 20 physicians and nine advanced practice professionals at a US urban academic health system. The surveys focused on the four domains of the US National Quality Forum framework: clinical effectiveness, patient experience, access to care, and financial impact.
Just over half (52%) of participants said they had previously used telehealth for 10 or more visits, while 10% had never used the technology to meet with a patient. Most participants specialized in either hematologic tumors (48%) or solid tumors (38%), with the remaining 14% general oncologists.
Heyer and team report that the respondents disagreed on the subject of clinical effectiveness, particularly regarding the effectiveness of virtual physical examinations. Some said they could not use telehealth to examine a sore throat, graft versus host disease, or shortness of breath, whereas others said that they could assess the mouth and skin, as well as respiratory distress.
Some perceived advantages of telehealth in terms of clinical effectiveness included the possibility of more frequent patient interactions and its usefulness for people with suspected communicable diseases, such as shingles, which may be a danger to other patients if seen in a clinic setting.
The key concerns among respondents about patient experience of telehealth included its inappropriateness for having discussions regarding serious or bad news, a decreased ability to bond with the patient, and the potential for patients to experience difficulty understanding complex treatment discussions.
However, some respondents felt that telehealth could improve the patient experience by improving access to care.
Indeed, most participants recognized that telehealth could improve care access, but some also pointed out that in certain cases telehealth may block access to care, such as for older patients not used to the technology, patients with a language barrier, and those whose socioeconomic status limits their access to technology.
Finally, Heyer and team found that the respondents had widely varying opinions on the financial impact of telehealth. Some said that it eliminates costs such as fuel, parking, and lost work time, whereas other suggested that patients feel they should not have to pay for a video visit. They also said that there was ambiguity surrounding insurance coverage status for telehealth.
The investigators conclude that their results “emphasize the need to address oncology patients’ access to telehealth technology, especially for older populations, and the acceptability of delivering serious or bad news as telehealth continues to change the landscape of patient-health professional interactions.”
They add that “further research is ongoing to assess current perceptions of health professionals and patients given the rapid expansion of telehealth during the COVID-19 pandemic.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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