Hanging connections in cancer survivorship care delivered via telehealth: Reflections from the Sydney Cancer Survivorship Centre multi-disciplinary team

ABSTRACT

Introduction: The Sydney Cancer Survivorship Centre (SCSC) runs a face-to-face multi-disciplinary team (MDT) visit for each new patient. This enables patients to be assessed by each member of the MDT. In March 2020 the clinic rapidly transitioned to telehealth delivery in response to the COVID-19 pandemic. Aim(s) To explore the experiences of delivering survivorship care via telehealth. Method(s) Using an interpretive descriptive qualitative methodology, we conducted focus groups (FG) and individual interviews with MDT members from SCSC. One FG was conducted in person, all others via the zoom platform. Discussions were audio-recorded and transcribed for analysis. Result(s) Thirteen people participated in three FG or two individual interviews. Four key themes were identified What is lost;Relationships;Logistical issues;and, Telehealth skills. Within 'Relationships' there were impacts on team relationships which became more fragmented without in person contact. With patients, telehealth was easier where relationships had already been established. Establishing rapport with new patients was more difficult. 'What is lost' identified the limited ability to garner visual cues, vital signs, and conduct physical examinations. While patient reported outcome measures assisted in overcoming some issues, without visual cues, assessment was more challenging. 'Logistical issues' were both positive and negative, with positive outcomes for patients reduced travel time, time off work, parking, and costs. Whereas, time required to prepare patients for the clinic was greater, engaging with interpreters challenging, and technical issues commonly compromised interactions. Participants noted telehealth requires specific skills from both staff and patients. Determining patients able to manage telehealth was challenging. Staff noted developing skills in telehealth, particularly how to detect more subtle cues or communicate effectively. Conclusion(s) The SCSC clinic transitioned successfully to telehealth. However, there is a need to improve telehealth platforms, skills of staff to communicate and assess patients, and management of patient flow through the clinic.