Rapid Utilization of Telehealth in a Comprehensive Cancer Center as a Response to COVID-19: Cross-Sectional Analysis

Abstract

Background: The emergence of the coronavirus disease (COVID-19) pandemic in March 2020 created unprecedented challenges in the provision of scheduled ambulatory cancer care. As a result, there has been a renewed focus on video-based telehealth consultations as a means to continue ambulatory care.

Objective: The aim of this study is to analyze the change in video visit volume at the University of California, San Francisco (UCSF) Comprehensive Cancer Center in response to COVID-19 and compare patient demographics and appointment data from January 1, 2020, and in the 11 weeks after the transition to video visits.

Methods: Patient demographics and appointment data (dates, visit types, and departments) were extracted from the electronic health record reporting database. Video visits were performed using a HIPAA (Health Insurance Portability and Accountability Act)-compliant video conferencing platform with a pre-existing workflow.

Results: In 17 departments and divisions at the UCSF Cancer Center, 2284 video visits were performed in the 11 weeks before COVID-19 changes were implemented (mean 208, SD 75 per week) and 12,946 video visits were performed in the 11-week post-COVID-19 period (mean 1177, SD 120 per week). The proportion of video visits increased from 7%-18% to 54%-72%, between the pre- and post-COVID-19 periods without any disparity based on race/ethnicity, primary language, or payor.

Conclusions: In a remarkably brief period of time, we rapidly scaled the utilization of telehealth in response to COVID-19 and maintained access to complex oncologic care at a time of social distancing.

Keywords: COVID-19; EHR; electronic health record; health informatics; pandemic; telehealth; video consultation; video visits.

Figure 1

Video visit workflow used at the University of California, San Francisco.

Figure 2

Number of clinic encounters stratified by visit type (in-person visits, procedural visits, video visits, and phone visits) from January 1 to May 31, 2020, with March 16, 2020, denoting the institution-wide transition to video visits in response to coronavirus disease (COVID-19).

Figure 3

Relative weekly trends in clinic encounters, stratified by visit type (in-person visits, procedural visits, video visits, and phone visits) from January 1 to May 31, 2020, with March 16, 2020, denoting the institution-wide transition to video visits in response to coronavirus disease (COVID-19).