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Using Telemedicine to Facilitate Patient Communication and Treatment Decision-Making Following Multidisciplinary Tumor Board Review for Patients with Hepatocellular Carcinoma.
Choi, Debra T; Sada, Yvonne H; Sansgiry, Shubhada; Kaplan, David E; Taddei, Tamar H; Aguilar, Jason K; Strayhorn, Michael; Hernaez, Ruben; Davila, Jessica A.
  • Choi DT; Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, TX, 77021, USA. debra.choi@bcm.edu.
  • Sada YH; Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. debra.choi@bcm.edu.
  • Sansgiry S; Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, TX, 77021, USA.
  • Kaplan DE; Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
  • Taddei TH; Section of Hematology and Oncology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
  • Aguilar JK; Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, TX, 77021, USA.
  • Strayhorn M; Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
  • Hernaez R; Veterans Affairs South Central Mental Illness Research Education and Clinical Center, Houston, TX, USA.
  • Davila JA; Department of Medicine, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
J Gastrointest Cancer ; 2022 Jun 30.
Article in English | MEDLINE | ID: covidwho-1906521
ABSTRACT
BACKGROUND AND

AIMS:

A rapid increase in the use of telemedicine for delivering healthcare has occurred since the onset of the Covid-19 pandemic. There is evidence for using telemedicine to facilitate cancer care delivery for patients with hepatocellular carcinoma (HCC). Examining how telemedicine can be used to communicate multidisciplinary tumor board (MTB) recommendations for HCC has not been studied. This study has two specific

aims:

(1) to evaluate the patient perspective of the MTB review process and identify best strategies for communicating treatment recommendations for HCC and (2) to pilot test a telemedicine intervention following MTB review to assess patient feasibility and satisfaction with using telemedicine to facilitate treatment decision-making and treatment referral.

METHODS:

We conducted a mixed-methods study. First, semi-structured qualitative interviews were conducted among patients diagnosed with HCC who were discussed in MTB review at one of three VA Medical Centers (VAMC). We collected information about the MTB process from the patient perspective and identified strategies for improving communication and delivery of care. Rapid qualitative analysis was used to inform intervention development. Using our qualitative data, a MTB telemedicine pilot intervention was developed and implemented to assess the feasibility of using this approach for patients with HCC.

RESULTS:

Almost all patients (94%) in the pilot study would recommend telemedicine to other patients with HCC, and half of the patients (50%) preferred telemedicine over in-person visits. Many patients (81%) found communication through telemedicine an acceptable platform to deliver difficult cancer information. Overall, patients felt they understood their treatment recommendations and found them clear and useful. Further, patients reported that they enjoyed being included in the decision-making process and appreciated being able to have family members easily join them for the telemedicine visit.

CONCLUSIONS:

Using telemedicine to communicate treatment recommendations following MTB review was found to be feasible and an acceptable alternative to an in-person visit for patient with HCC. Future studies could include expanding this approach for communicating MTB recommendations to patients with other types of cancers.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Qualitative research Language: English Year: 2022 Document Type: Article Affiliation country: S12029-022-00844-w

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Qualitative research Language: English Year: 2022 Document Type: Article Affiliation country: S12029-022-00844-w