University of Wisconsin, Madison, WI.
Carbone Cancer Center, Madison, WI.
JCO Oncol Pract. 2021 Sep;17(9):e1318-e1326. doi: 10.1200/OP.21.00195. Epub 2021 Jul 15.
The use of telemedicine expanded dramatically in March 2020 following the COVID-19 pandemic. We sought to assess oncologist perspectives on telemedicine's present and future roles (both phone and video) for patients with cancer.
The National Comprehensive Cancer Network (NCCN) Electronic Health Record (EHR) Oncology Advisory Group formed a Workgroup to assess the state of oncology telemedicine and created a 20-question survey. NCCN EHR Oncology Advisory Group members e-mailed the survey to providers (surgical, hematology, gynecologic, medical, and radiation oncology physicians and clinicians) at their home institution.
Providers (N = 1,038) from 26 institutions responded in Summer 2020. Telemedicine (phone and video) was compared with in-person visits across clinical scenarios (n = 766). For reviewing benign follow-up data, 88% reported video and 80% reported telephone were the same as or better than office visits. For establishing a personal connection with patients, 24% and 7% indicated video and telephone, respectively, were the same as or better than office visits. Ninety-three percent reported adverse outcomes attributable to telemedicine visits never or rarely occurred, whereas 6% indicated they occasionally occurred (n = 801). Respondents (n = 796) estimated 46% of postpandemic visits could be virtual, but challenges included (1) lack of patient access to technology, (2) inadequate clinical workflows to support telemedicine, and (3) insurance coverage uncertainty postpandemic.
Telemedicine appears effective across a variety of clinical scenarios. Based on assessment, a substantial fraction of visits for patients with cancer could be effectively and safely conducted using telemedicine. These findings should influence regulatory and infrastructural decisions regarding telemedicine postpandemic for patients with cancer.
在 COVID-19 大流行之后，远程医疗在 2020 年 3 月大幅扩张。我们旨在评估肿瘤学家对电话和视频远程医疗在癌症患者中的当前和未来作用的看法。
美国国家综合癌症网络（NCCN）电子病历（EHR）肿瘤学咨询组成立了一个工作组来评估肿瘤学远程医疗的现状，并创建了一个包含 20 个问题的调查。NCCN EHR 肿瘤学咨询组的成员将调查通过电子邮件发送到他们所在机构的提供者（外科、血液学、妇科、内科和放射肿瘤学医生和临床医生）。
2020 年夏季，来自 26 个机构的提供者（N = 1,038）做出了回应。在各种临床情况下（n = 766），将远程医疗（电话和视频）与面对面就诊进行了比较。对于审查良性随访数据，88%的人报告视频和 80%的人报告电话与办公室就诊一样或更好。为了与患者建立个人联系，24%和 7%的人分别表示视频和电话与办公室就诊一样或更好。93%的人报告远程医疗就诊从未或很少发生不良后果，而 6%的人表示偶尔会发生（n = 801）。受访者（n = 796）估计大流行后 46%的就诊可以是虚拟的，但挑战包括（1）患者缺乏获取技术的途径，（2）支持远程医疗的临床工作流程不足，以及（3）大流行后保险覆盖范围的不确定性。
远程医疗在各种临床情况下似乎都很有效。根据评估，癌症患者的大量就诊可以通过远程医疗有效地、安全地进行。这些发现应该影响大流行后癌症患者远程医疗的监管和基础设施决策。
