ONE YEAR OF TELEMEDICINE IN THE MANAGEMENT OF GENITOURINARY MALIGNANCIES

ABSTRACT

INTRODUCTION AND OBJECTIVE: The use of telemedicine in management of genitourinary malignancies has expanded greatly in the context of the COVID-19 pandemic. We aimed to evaluate patient perspectives across the first year of widespread telemedicine use at our institution. METHODS: We conducted a prospective survey study from July 2020 through June 2021 of patients who had telemedicine visits with urology, medical oncology, or radiation oncology for management of genitourinary malignancies. Patients received a questionnaire regarding the telemedicine experience. Responses were scored on a 5- point Likert scale. The primary outcome was patient satisfaction. RESULTS: We received 134 survey responses. Overall, 100 patients (75%) reported being “extremely satisfied” with the telemedicine encounter, and 100 patients (75%) “strongly agreed” that they were able to discuss sensitive topics about cancer care as well as they could at an in-person visit. On ordinal logistic regression adjusting for patient age and gender, patient satisfaction scores decreased over time (OR 0.88 per month, 95% CI 0.78-0.99, p=0.042, Figure). In particular, patients were less satisfied over time with the explanations they received about their condition, the concern their physicians showed for their questions, the information they received about treatment options, the instructions they received about follow-up care, and the amount of time the physicians spent with them (all p<0.05). Technological barriers to telemedicine were encountered by 16 patients (12%), and these were associated with lower patient satisfaction (p<0.001). The rate of technological barriers did not significantly change over time, though it was associated with increasing patient age. CONCLUSIONS: While the majority of patients are satisfied with telemedicine for management of genitourinary malignancies, satisfaction has decreased after the early months of the COVID-19 pandemic, particularly with regard to patient counseling and time spent. Additionally, technological barriers to telemedicine implementation remain common, particularly among the elderly. (Figure Presented).