Chimonas Susan, Lipitz-Snyderman Allison, Spiegelhoff Zoe, Chakraborty Nirjhar, Seier Kenneth, White Charlie, Kuperman Gilad
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Department of Health Informatics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Cancers (Basel). 2023 Oct 12;15(20):4961. doi: 10.3390/cancers15204961.
While COVID-19 catalyzed a shift to telemedicine, little is known about the persistence of remote cancer care in non-emergent times. We assessed telemedicine use at a high-volume academic cancer center in New York City and analyzed breast and prostate cancer visits pre-COVID-19, peak COVID-19, and post-peak. Descriptive statistics assessed visit mode (in person, telemedicine) and type (new, follow-up, other) by department/specialty, with Fisher's exact tests comparing peak/post-peak differences. The study included 602,233 visits, with telemedicine comprising 2% of visits pre-COVID-19, 50% peak COVID-19, and 30% post-peak. Notable variations emerged by department/specialty and visit type. Post-peak, most departments/specialties continued using telemedicine near or above peak levels, except medicine, neurology, and survivorship, where remote care fell. In psychiatry, social work, and nutrition, nearly all visits were conducted remotely during and after peak COVID-19, while surgery and nursing maintained low telemedicine usage. Post-peak, anesthesiology and neurology used telemedicine seldom for new visits but often for follow-ups, while nursing showed the opposite pattern. These trends suggest department- and visit-specific contexts where providers and patients choose telemedicine in non-emergent conditions. More research is needed to explore these findings and evaluate telemedicine's appropriateness and impact across the care continuum.
虽然新冠疫情促使医疗模式向远程医疗转变，但在非紧急情况下远程癌症护理的持续性却鲜为人知。我们评估了纽约市一家大型学术癌症中心的远程医疗使用情况，并分析了新冠疫情前、疫情高峰期和高峰期过后乳腺癌和前列腺癌患者的就诊情况。描述性统计按科室/专业评估就诊模式（面对面、远程医疗）和类型（初诊、复诊、其他），采用Fisher精确检验比较高峰期与高峰期过后的差异。该研究纳入了602,233次就诊，其中远程医疗在新冠疫情前占就诊次数的2%，疫情高峰期占50%，高峰期过后占30%。不同科室/专业和就诊类型出现了显著差异。高峰期过后，除内科、神经科和癌症康复科远程护理减少外，大多数科室/专业继续以接近或高于高峰期的水平使用远程医疗。在精神科、社会工作科和营养科，几乎所有就诊在新冠疫情期间及过后都是通过远程方式进行的，而外科和护理的远程医疗使用率较低。高峰期过后，麻醉科和神经科很少将远程医疗用于初诊，但常用于复诊，而护理则呈现相反的模式。这些趋势表明，在非紧急情况下，医护人员和患者选择远程医疗存在科室和就诊类型的特定背景。需要更多研究来探索这些发现，并评估远程医疗在整个护理过程中的适用性和影响。
