Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
JAMA Netw Open. 2021 Jan 4;4(1):e2033967. doi: 10.1001/jamanetworkopen.2020.33967.
Telehealth has emerged as a means of improving access and reducing cost for medical oncology care; however, use by specialists prior to the coronavirus disease 2019 (COVID-19) pandemic still remained low. Medical oncology professionals' perceptions of telehealth for cancer care are largely unknown, but are critical to telehealth utilization and expansion efforts.
To identify medical oncology health professionals' perceptions of the barriers to and benefits of telehealth video visits.
DESIGN, SETTING, AND PARTICIPANTS: This qualitative study used interviews conducted from October 30, 2019, to March 5, 2020, of medical oncology health professionals at the Thomas Jefferson University Hospital, an urban academic health system in the US with a cancer center. All medical oncology physicians, physicians assistants, and nurse practitioners at the hospital were eligible to participate. A combination of volunteer and convenience sampling was used, resulting in the participation of 29 medical oncology health professionals, including 20 physicians and 9 advanced practice professionals, in semistructured interviews.
Medical oncology health professionals' perceptions of barriers to and benefits of telehealth video visits as experienced by patients receiving cancer treatment.
Of the 29 participants, 15 (52%) were women and 22 (76%) were White, with a mean (SD) age of 48.5 (12.0) years. Respondents' perceptions were organized using the 4 domains of the National Quality Forum framework: clinical effectiveness, patient experience, access to care, and financial impact. Respondents disagreed on the clinical effectiveness and potential limitations of the virtual physical examination, as well as on the financial impact on patients. Respondents also largely recognized the convenience and improved access to care enabled by telehealth for patients. However, many reported concern regarding the health professional-patient relationship and their limited ability to comfort patients in a virtual setting.
Medical oncology health professionals shared conflicting opinions regarding the barriers to and benefits of telehealth in regard to clinical effectiveness, patient experience, access to care, and financial impact. Understanding oncologists' perceptions of telehealth elucidates potential barriers that need to be further investigated or improved for telehealth expansion and continued utilization; further research is ongoing to assess current perceptions of health professionals and patients given the rapid expansion of telehealth during the COVID-19 pandemic.
远程医疗已成为改善医疗肿瘤学护理的获取途径和降低成本的手段；然而，在 2019 年冠状病毒病（COVID-19）大流行之前，专家们的使用仍然很低。医学肿瘤学专业人员对癌症护理远程医疗的看法在很大程度上是未知的，但对于远程医疗的使用和扩展工作至关重要。
确定医疗肿瘤学健康专业人员对远程医疗视频访问的障碍和益处的看法。
设计、设置和参与者：这项定性研究使用了 2019 年 10 月 30 日至 2020 年 3 月 5 日在托马斯杰斐逊大学医院（美国城市学术卫生系统，拥有癌症中心）进行的医疗肿瘤学健康专业人员访谈。医院的所有肿瘤学医生、医生助理和执业护士都有资格参加。采用志愿者和便利抽样相结合的方法，共有 29 名医疗肿瘤学健康专业人员参加了半结构式访谈，其中包括 20 名医生和 9 名高级实践专业人员。
接受癌症治疗的患者对远程医疗视频访问的障碍和益处的看法。
29 名参与者中，15 名（52%）为女性，22 名（76%）为白人，平均（SD）年龄为 48.5（12.0）岁。受访者的观点组织使用了国家质量论坛框架的 4 个领域：临床效果、患者体验、获得护理的机会和财务影响。受访者对虚拟体检的临床效果和潜在局限性以及对患者的财务影响存在分歧。受访者还普遍认识到远程医疗为患者提供的便利和改善的护理机会。然而，许多人对健康专业人员与患者的关系以及他们在虚拟环境中安慰患者的能力有限表示担忧。
医疗肿瘤学健康专业人员对远程医疗在临床效果、患者体验、获得护理的机会和财务影响方面的障碍和益处存在不同意见。了解肿瘤学家对远程医疗的看法，可以阐明需要进一步调查或改进的远程医疗扩展和持续利用的潜在障碍；正在进行进一步的研究，以评估在 COVID-19 大流行期间远程医疗迅速扩张的情况下，专业人员和患者目前的看法。
