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. 2021 Sep;17(9):e1354-e1361.
doi: 10.1200/OP.21.00144. Epub 2021 Aug 5.

Virtual Cancer Care During the COVID-19 Pandemic in Alberta: Evidence From a Mixed Methods Evaluation and Key Learnings

Linda Watson  1   2 , Siwei Qi  1 , Andrea Delure  1 , Claire Link  1 , Eclair Photitai  1 , Lindsi Chmielewski  1 , April Hildebrand  1 , Dean Ruether  2   3 , Krista Rawson  4
Affiliations

Virtual Cancer Care During the COVID-19 Pandemic in Alberta: Evidence From a Mixed Methods Evaluation and Key Learnings

Linda Watson et al. JCO Oncol Pract. 2021 Sep.

Abstract

Purpose: This study reports on a mixed methods evaluation conducted within a provincial cancer program in Alberta, Canada. The purpose was to capture key learnings from a rapid virtual care implementation because of the COVID-19 pandemic and to understand the impact on patient and staff experiences.

Methods: Administrative data were collected for 21,362 patients who had at least one virtual or in-person visit to any provincial cancer center from April 1, 2020, to June 10, 2020. Patient surveys were conducted with 397 randomly selected patients who had received a virtual visit. Surveys were also conducted with 396 Cancer Care Alberta staff.

Results: 14,906 virtual visits took place in this period, and about 40% of weekly visits were virtual. Significant differences were observed in both patient-reported symptom questionnaire completion rates and referrals to supportive care services between patients seen in-person and virtually. Patients receiving active treatments reported significantly lower levels of satisfaction with virtual visits than those seen for follow-up, but overall 90% of patients indicated interest in receiving virtual care in the future. Staff thought virtual visits increased patients' access to care but less than one third (31.5%) felt confident meeting patients' emotional needs and having conversations about disease progression and/or end of life virtually.

Conclusion: The COVID-19 pandemic has driven the rapid implementation of virtual visits for cancer care delivery in health care settings. The findings from this mixed methods evaluation provide a concrete set of considerations for organizations looking to develop a large-scale, enduring virtual care strategy.

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Conflict of interest statement

Dean RuetherHonoraria: Astellas Pharma, Bayer, Eisai, Ipsen, Janssen Oncology, Novartis Canada Pharmaceuticals Inc, Pfizer, Sanofi/AventisConsulting or Advisory Role: Astellas Pharma, Bayer, Eisai, Ipsen, Janssen Oncology, Novartis, Pfizer, SanofiNo other potential conflicts of interest were reported.

Figures

FIG 1.
FIG 1.
Weekly visits (virtual plus in-person) and COVID-19 cases in Alberta (April 1-June 9, 2020).
FIG 2.
FIG 2.
Supportive care referrals (April 1, 2020-June 10, 2020). CO, community oncology; OT, occupational therapy.
FIG 3.
FIG 3.
Percentage of staff who were confident or extremely confident in addressing the following patient needs virtually.
See this image and copyright information in PMC

References

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    1. Bokolo A: Use of telemedicine and virtual care for remote treatment in response to COVID-19 pandemic. J Med Syst 44:132, 2020 - PMC - PubMed
    1. Mann D, Chen J, Chunara R: COVID-19 transforms health care through telemedicine: Evidence from the field. J Am Med Inform Assoc 27:1132-1135, 2020 - PMC - PubMed
    1. Alberta Health Services : Cancer Control Alberta. Virtual Health Implementation Plan [internal document], 2020
    1. Alberta Innovates : A pRoject Ethics Community Consensus Initiative (ARECCI), 2021. https://albertainnovates.ca/programs/arecci/

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