Physician Perspectives on Telemedicine in Radiation Oncology

Abstract

Purpose: Telemedicine enthusiasm and uptake in radiation oncology rapidly increased during the COVID-19 pandemic, but it is unclear if and how telemedicine should be used after the COVID-19 public health emergency ends is unclear. Herein, we report on our institution's provider experience after the mature adoption of telemedicine.

Methods and materials: We distributed a survey to all radiation oncology attending physicians at our institution in October 2021 to assess satisfaction, facilitators, and barriers to telemedicine implementation. We performed quantitative and qualitative analyses to characterize satisfaction and identify influencing factors whether telemedicine is employed. We calculated the average proportion of visits that providers expected to be appropriately performed with telemedicine for each disease site and visit type.

Results: A total of 60 of the 82 eligible radiation oncologists (73%) responded to the survey, of whom 78% were satisfied with telemedicine in the radiation oncology department and 83% wished to continue offering video visits after the COVID-19 public health emergency ends. Common patient factors influencing whether physicians offer telemedicine include the patient's travel burden, patient preferences, and whether a physical examination is required. Approximately 20% of new consultations and 50% of weekly management visits were estimated to be appropriate for telemedicine. The central nervous system/pediatrics and thoracic faculty considered telemedicine appropriate for the greatest proportion of new consultations, and 93% of respondents felt comfortable determining whether telemedicine was appropriate.

Conclusions: Surveyed radiation oncologists were satisfied with telemedicine in their practice, and wished to continue offering video visits in the future. Our data suggest that payers should continue to support this patient-centered technology.

Figure 1

Percentage of respondents who strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with several measures of satisfaction with telemedicine.

Figure 2

Percent of respondents (n = 60) who reported the listed, (A) patient factors in their top 3 as most important when deciding whether to use telemedicine for a visit; (B) system factors in their top 3 as most important to influence whether they use telemedicine in the future; and (C) factors as most important reason for not performing telemedicine more often.

Figure 2

Percent of respondents (n = 60) who reported the listed, (A) patient factors in their top 3 as most important when deciding whether to use telemedicine for a visit; (B) system factors in their top 3 as most important to influence whether they use telemedicine in the future; and (C) factors as most important reason for not performing telemedicine more often.

Figure 3

Median percent of each visit type appropriate for telemedicine as estimated by providers affiliated with only a single disease site. There were no single-service genitourinary faculty who responded to this question, so they are excluded from this analysis.