Telemedicine Perspectives in Radiation Oncology

ABSTRACT

Given the changes to Radiation Oncology clinic workflow inspired by the COVID-19 pandemic, this study sought to determine the attitudes and perceptions of radiation oncologists towards the integration of telemedicine in the clinical setting. An online survey was sent nationwide to radiation oncologists, accompanied by a $10 gift card incentive for completing the survey. Of 117 complete responses received, the majority of respondents reported practicing in an academic setting (92%) and in an urban area (95%). 42% of respondents were still in training, while the rest had graduated from residency 0-5 years (16%), 6-10 years (8%), 11-20 years (15%), and 21+ years (19%) ago. Of all respondents, 79% worked at institutions that had implemented a work-from-home policy. Satisfaction was reported to be 87% regarding work-from-home flexibility, 84% regarding decreased commute to work, 40% regarding interaction with patients, 46% regarding impact on workflow, and 76% regarding overall impression. Before COVID-19, 99% of all visits were completed in-person whereas after COVID-19, telephone and telemedicine video visits comprised approximately 35% of new patient consults, 12% of on-treatment visits (OTVs), and 51% of follow-up visits. The primary factors in determining whether a patient was seen via telemedicine were patient preference (46%), physician preference (32%), and department policy (22%). Overall, in-person visits were felt to be better than telemedicine encounters in obtaining information during consultation (55%), establishing a personal connection with the patient/family (89%), answering questions about radiation treatment (45%), assessing for toxicity while on-treatment (87%), and assessing for toxicity/recurrence during follow-up (70%). 70% of respondents were in favor of more telemedicine utilization even after the COVID-19 pandemic, while 22% were in favor of telemedicine use only during the pandemic, and 8% were against the use of telemedicine unless absolutely necessary. Telemedicine visits for OTV encounters were deemed somewhat appropriate or extremely appropriate by 86% of respondents for patients confirmed to be COVID-positive, 79% for patients with mild symptoms who had not been tested, 65% for asymptomatic patients living with an at-risk person, 57% for asymptomatic patients who had recently traveled to a high-risk zone within the last 14 days, 92% for physician with mild symptoms who had not been tested, and 89% for asymptomatic physician living with an at-risk person. Telemedicine has become quickly integrated into the Radiation Oncology clinical workflow allowing for convenience, flexibility, and minimization of infection transmission. These encounters are likely to play a role in conjunction with – not in place of – in-person visits, which allow physicians the ability to obtain crucial information during consultation, establish a personal connection with patients, and assess for toxicity/recurrence. [ABSTRACT FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)