The role of telehealth in improving patient care and satisfaction during a pandemic: University of California Cancer Consortium experience

ABSTRACT

Background: The adoption of telemedicine in providing patient-centric care has been limited due to concerns related to upfront cost and the uncertain reimbursement models. Telehealth modalities, which encompass broader services, quickly became a central focus of how we delivered care in cancer centers across the nation during the COVID-19 (C19) pandemic. Our aim is to describe five University of California (UC) Cancer Centers' experience with telehealth during the pandemic. Methods: Between March and June 2020, UC Cancer Centers developed or increased the use of telehealth modalities to continue to provide care to our oncology patients during the pandemic. Digital platforms were used to screen for symptoms and exposures related to C19, as well as for symptoms of distress. In addition, providers performed remote visits via video and telephone visits. Each of our centers monitored visit volumes as well as patient satisfaction scores during the pandemic. Results: Our Cancer Centers, each with various levels of pre-pandemic (Jan-Feb) use of telehealth, saw an increase in the volume of patients who were seen via remote visits including video and telephone visits during the pandemic (Mar-Apr). UC Davis, UC Los Angeles and UC San Francisco had implemented telemedicine prior to the pandemic, but the rates of use were 1%, 0.4% and 7%, respectively. In contrast, UC Irvine and UC San Diego did not offer remote visits prior to the pandemic. Despite these differences, during the pandemic, telemedicine rates increased to 50-70% of visits in the cancer centers. In addition, patient satisfaction scores were comparable to in-clinic visits. The use of digital platforms allowed 80% of patients to be screened for risk of C19 prior to their in-clinic visits. Conclusions: While differing levels of implementation was in place for telehealth services in our cancer centers prior to the pandemic, each cancer center was able to continue to see patients via remote visits. In addition, telehealth technology automated activities that would have been performed manually pre-pandemic. The increased use of telemedicine visits with high patient satisfaction scores is an indication that some patients can continue to receive their care via telehealth beyond the pandemic.