Parameswaran Vijaya, Miller Marci, Pritchett Joshua, Demaerschalk Bart, Hu Yue, Tsung Sean, Zeng Yan Bo, Rosengaus Leah, Sharp Christopher, Lee Byrne, Shah Sumit
Department of Medicine, Stanford University, Digital Health Care Integration Team, Stanford Medicine, Palo Alto, CA, USA.
Digital Health Care Integration Team, Stanford Medicine, Palo Alto, CA, USA.
Ann Surg Oncol. 2025 Jun 11. doi: 10.1245/s10434-025-17592-3.
Telemedicine is now a sustained modality of ambulatory surgical oncology care, yet its association with workforce utilization, patient volume, and visit type at high-volume academic centers remains understudied. Characterizing these patterns is essential for guiding clinical operations and long-term integration of telemedicine into surgical oncology practice.
We conducted a retrospective cohort study across nine oncology subspecialties at Stanford Medicine's ambulatory surgical oncology clinics from January 2019 to December 2023 to compare yearly visit volumes and telemedicine use. The study included a total of 231,746 visits, including 50,667 new and 181,079 return visits. We measured overall visit volumes, telemedicine utilization, and their association with increase in unique patients served, including both new and return visits.
In 2023, visit volumes increased by 44% (46,726 to 67,259), and the clinician workforce grew by 16.8% (107 to 125) compared with 2019. The number of unique patients served rose by 39% (20,620 to 28,711), while visits per patient remained stable (2.3 ± 2.1 to 2.3 ± 2.2). Telemedicine use increased from 0.5% (244/46,726) to 37% (24,906/67,259), correlating with serving more patients per year (r = 0.776, p = 0.030) and return visits (r = 0.796, p = 0.010), but not new visits (r = 0.432, p = 0.245).
At this academic medical center, telemedicine use is associated with an expansion of the clinician workforce, an increase in patient volume, and more return visits rather than new visits, without contributing to overall higher healthcare utilization. This suggests that telemedicine can deliver a significant proportion of ambulatory surgical oncological visits while preserving access to care and operational efficiency.
远程医疗现已成为门诊手术肿瘤学护理的一种持续模式，但在大型学术中心，其与劳动力利用、患者数量和就诊类型之间的关联仍未得到充分研究。了解这些模式对于指导临床操作以及将远程医疗长期融入手术肿瘤学实践至关重要。
我们对斯坦福医学门诊手术肿瘤学诊所2019年1月至2023年12月期间九个肿瘤学亚专业进行了一项回顾性队列研究，以比较年度就诊量和远程医疗的使用情况。该研究共纳入231,746次就诊，包括50,667次初诊和181,079次复诊。我们测量了总体就诊量、远程医疗利用率及其与服务的独特患者数量增加之间的关联，包括初诊和复诊。
与2019年相比，2023年就诊量增加了44%（从46,726次增至67,259次），临床医生劳动力增长了16.8%（从107人增至125人）。服务的独特患者数量增加了39%（从20,620人增至28,711人），而每位患者的就诊次数保持稳定（从2.3±2.1次增至2.3±2.2次）。远程医疗的使用从0.5%（244/46,726）增至37%（24,906/67,259），这与每年服务更多患者（r = 0.776，p = 0.030）和复诊（r = 0.796，p = 0.010）相关，但与初诊无关（r = 0.432，p = 0.245）。
在这个学术医疗中心，远程医疗的使用与临床医生劳动力的扩大、患者数量的增加以及更多的复诊而非初诊相关，且不会导致整体医疗利用率的提高。这表明远程医疗可以在保持医疗可及性和运营效率的同时，提供相当比例的门诊手术肿瘤学就诊服务。
