Physician Perspectives on Telemedicine Implementation in Radiation Oncology

ABSTRACT

Background: The use of telemedicine in radiation oncology increased dramatically during the COVID-19 pandemic. While prior surveys suggest high levels of satisfaction with telemedicine among radiation oncologists, the published literature is limited regarding provider-specific factors impacting satisfaction and provider preferences regarding how telemedicine is implemented. Objective(s) To assess provider characteristics associated with satisfaction and perceived adoption of telemedicine in radiation oncology, and to characterize implementation preferences of providers at our institution. Method(s) We distributed a survey to all attending radiation oncologists at our large academic institution in October 2021 to assess several measures of satisfaction with telemedicine. We also asked providers to estimate metrics suggestive of successful telemedicine use. Univariate logistic regressions were performed to assess the role of physician characteristics (including age, gender, years in practice, main vs satellite location, disease site treated, annual new patient volume, and selfreported comfort with technology) on satisfaction and on whether physicians reported telemedicine was easy to use. We also performed descriptive statistics to characterize provider-estimated time-savings and training preferences. Kruskal-Wallis tests were used to assess whether provider characteristics or scheduling strategy (telemedicine scheduled separately from in-person visits) were associated with the rate of missed video visits. Result(s) A total of 60 of 82 eligible radiation oncologists (73%) responded to the survey. 78% of respondents were satisfied with telemedicine in the radiation oncology department and 78% felt telemedicine was easy to use. None of the tested factors on univariate analysis were statistically significant predictors for these outcomes. 38% of providers believed telemedicine encounters resulted in time savings of at least 10% compared to in-person visits, while 20% of providers reported virtual encounters took at least 10% more time. A median (IQR) of 10% (5%-20%) of video visits were estimated to be missed, and none of the tested provider characteristics or scheduling preferences were associated with a significantly greater proportion of missed visits. 78% of respondents reported having adequate training and support to perform telemedicine. Text, video, and private instruction were nearly equally preferred training modalities (31%, 31%, 34% respectively). Conclusion(s) Nearly 80% of surveyed radiation oncologists were satisfied with telemedicine, felt it was easy to use, and reported adequate training and support to perform telemedicine. In this highly technologically advanced field, age and years in practice were not significantly associated with satisfaction or self-reported success rates with telemedicine. Future directions include addressing actionable concerns and correlating these findings with patient impressions.