Radiation oncologist perceptions of telemedicine from consultation to treatment planning: A mixed-methods study Journal Article


Authors: Zhang, H.; Cha, E. E.; Lynch, K.; Cahlon, O.; Gomez, D. R.; Shaverdian, N.; Gillespie, E. F.
Article Title: Radiation oncologist perceptions of telemedicine from consultation to treatment planning: A mixed-methods study
Abstract: Purpose: Telemedicine was rapidly implemented for initial consultations and radiation treatment planning in the wake of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we explore utilization of and physician perspectives on this approach in an attempt to identify patient populations that may benefit most from virtual care. Methods and Materials: This is a mixed-methods study with a convergent design. Approximately 6 to 8 weeks after implementation of telemedicine, all radiation oncologists in a single academic radiation oncology department were invited to participate in either semistructured interviews with embedded survey questions or a concurrently administered survey only. Rapid qualitative analysis was used to identify common themes, and quantitative data was assessed using descriptive statistics and univariable analyses. Results: At the apex of the pandemic, 92% of radiation oncology visits were conducted via telemedicine. In total, 51 of 61 radiation oncologists participated in the study (response rate 84%). Most (71%) reported no difference in ability to treat cancer appropriately via telemedicine, which was more common among specialized physicians (P = .01) but not those with higher visit volume or years of experience. Over half (55%) perceived no difference or even improvement in overall visit quality with telemedicine. Virtual visits were deemed acceptable for a median of 70% to 96% of patients, which varied by disease site. Need for physical examination, and availability of an acceptable proxy, factored into telemedicine acceptability. Most (88%) found telemedicine better than expected, but opinions were split on how telemedicine would affect physician burnout. Almost all (96%) foresaw a role for telemedicine beyond the pandemic and would opt for a median of 50% (interquartile range 20%-66%) of visits conducted via telemedicine. Conclusions: Among radiation oncologists in an academic setting, telemedicine was perceived to be highly appropriate and acceptable for most patients. Future studies should focus on identifying the 5% to 30% of patients whose care may be optimized with in-person visits, and if there is alignment with patient preferences. © 2020 Elsevier Inc.
Keywords: treatment planning; cancer radiotherapy; psychology; health survey; editorial; cancer therapy; questionnaire; statistical analysis; radiation oncology; quantitative analysis; referral and consultation; workload; consultation; physical examination; radiotherapy planning, computer-assisted; univariate analysis; patient referral; virus pneumonia; radiation oncologists; perception; semi structured interview; qualitative analysis; telemedicine; pandemic; workflow; attitude to computers; pneumonia, viral; humans; human; male; female; priority journal; radiotherapy planning system; radiation oncologist; coronavirus infections; surveys and questionnaires; professional burnout; coronavirus infection; pandemics; coronavirus disease 2019; mixed method
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 108
Issue: 2
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2020-10-01
Start Page: 421
End Page: 429
Language: English
DOI: 10.1016/j.ijrobp.2020.07.007
PUBMED: 32890525
PROVIDER: scopus
PMCID: PMC7462757
DOI/URL:
Notes: Editorial -- Export Date: 1 October 2020 -- Source: Scopus
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MSK Authors
  1. Oren Cahlon
    158 Cahlon
  2. Daniel R Gomez
    237 Gomez
  3. Erin Faye Gillespie
    149 Gillespie
  4. Kathleen A Lynch
    71 Lynch
  5. Elaine Cha
    9 Cha
  6. Yue Helen Zhang
    11 Zhang