Subject(s)
Coronavirus Infections/epidemiology , Magnetic Resonance Imaging , Pandemics , Pneumonia, Viral/epidemiology , Radiation Oncology , COVID-19 , Evidence-Based Medicine , Humans , Magnetic Resonance Imaging/economics , Magnetic Resonance Imaging/statistics & numerical data , Radiation Oncology/economics , Radiation Oncology/statistics & numerical dataSubject(s)
COVID-19/epidemiology , Neoplasms/radiotherapy , Pandemics , Radiation Oncology , Delayed Diagnosis/adverse effects , Delivery of Health Care/trends , Fear , Forecasting , Health Resources/supply & distribution , Health Services Accessibility/economics , Health Services Accessibility/statistics & numerical data , Humans , Mortality/trends , Neoplasms/diagnosis , Neoplasms/mortality , Neoplasms/psychology , Patient Acceptance of Health Care/statistics & numerical data , Radiation Dose Hypofractionation/standards , Radiation Oncology/economics , Radiation Oncology/standards , Radiation Oncology/trends , Telemedicine/organization & administration , UnemploymentABSTRACT
PURPOSE: Health systems have increased telemedicine use during the SARS-CoV-2 outbreak to limit in-person contact. We used time-driven activity-based costing to evaluate the change in resource use associated with transitioning to telemedicine in a radiation oncology department. METHODS AND MATERIALS: Using a patient undergoing 28-fraction treatment as an example, process maps for traditional in-person and telemedicine-based workflows consisting of discrete steps were created. Physicians/physicists/dosimetrists and nurses were assumed to work remotely 3 days and 1 day per week, respectively. Mapping was informed by interviews and surveys of personnel, with cost estimates obtained from the department's financial officer. RESULTS: Transitioning to telemedicine reduced provider costs by $586 compared with traditional workflow: $47 at consultation, $280 during treatment planning, $237 during on-treatment visits, and $22 during the follow-up visit. Overall, cost savings were $347 for space/equipment and $239 for personnel. From an employee perspective, the total amount saved each year by not commuting was $36,718 for physicians (7243 minutes), $19,380 for physicists (7243 minutes), $17,286 for dosimetrists (7210 minutes), and $5599 for nurses (2249 minutes). Patients saved $170 per treatment course. CONCLUSIONS: A modified workflow incorporating telemedicine visits and work-from-home capability conferred savings to a department as well as significant time and costs to health care workers and patients alike.