ABSTRACT
Introduction: The use of telemedicine in the oncology (Onc) setting expanded after March 2020 due to the COVID-19 pandemic. Patients and providers report satisfaction with telemedicine within the context of acute pandemic needs (Darcourt et al, JOP, 2020). We assessed provider perspectives on the roles of phone- and video-based telemedicine in the Onc setting. Methods: The NCCN EHR Oncology Advisory Group formed a Workgroup to assess the state of Onc telemedicine, creating a 20-question survey distributed to all 30 NCCN Member Institutions. An NCCNmember was responsible for emailing the survey to the Onc providers (surgery, hematology, gynecologic, medical and radiation oncology physicians & APPs) at his/her institution. Results: N51,038 individuals from 26 institutions (institution response rate 87%) responded 7-8/2020. Respondents were largely Onc physicians (58%) with >5 years of practice experience (72%). Few respondents had participated in telemedicine visits of any kind prior to the COVID-19 pandemic (19%;n=198/1038). At the time of the survey, most had participated in both telephone and videobased visits (84%;n=872/1038);5% (n=52/1038) had participated in only phone-based visits and 9% (=93/ 1038) had participated in only video-based visits. Only 2% of respondents (n=21/1038) reported not having conducted any telemedicine visits. The use of telemedicine was based on provider discretion (88%;n=727/826) and patient preference (81%;=669/826). Importantly, 94% (n=753/801) of respondents indicated rarely-to-never encountering adverse outcomes attributable to having had a telemedicine visit rather than an in-person visit. The Figure indicates how telemedicine visits compared to office visits for particular tasks commonly associated with Onc visits. Respondents (n=796) estimated 33% of patients could safely be seen using video visits and 13% using phone visits post-pandemic. Challenges include lack of: 1) patient access to technology for video visits, 2) clinical workflows to support telemedicine, and 3) certainty about future insurance coverage. Conclusion: Based on Onc provider assessment, a substantial fraction of patient visits could be effectively, safely conducted using telemedicine post-pandemic. Overall, video visits were viewed more favorably than phone visits with greater utility over a wider range of clinical scenarios. Careful thought should be given to modifying regulations to maintain telemedicine for use post-pandemic.