When is telemedicine appropriate in the management of head and neck cancer? A mixed-methods assessment among patients and physicians Journal Article


Authors: Hung, T. K. W.; Verdini, N. P.; Gilliland, J. L.; Chimonas, S.; Cracchiolo, J. R.; Li, Y.; Pfister, D. G.; Gillespie, E. F.
Article Title: When is telemedicine appropriate in the management of head and neck cancer? A mixed-methods assessment among patients and physicians
Abstract: PURPOSE: Evidence suggests that oncology patients are satisfied with and sometimes prefer telemedicine compared with in-person visits; however, data are scarce on when telemedicine is appropriate for specific cancer populations. In this study, we aim to identify factors that influence patient experience and appropriateness of telemedicine use among a head and neck cancer (HNC) population. METHODS: We performed a mixed-methods study at a multisite cancer center. First, we surveyed patients with HNC and analyzed factors that may influence their telemedicine experience using multivariate regression. We then conducted focus groups among HNC oncologists (n = 15) to evaluate their perception on appropriate use of telemedicine. RESULTS: From January to December 2020, we collected 1,071 completed surveys (response rate 24%), of which 551 first unique surveys were analyzed. About half of all patients (56%) reported telemedicine as "same or better" compared with in-person visits, whereas the other half (44%) reported "not as good or unsure." In multivariate analyses, patients with thyroid cancer were more likely to find telemedicine "same or better" (adjusted odds ratio, 2.08 [95% CI, 1.35 to 3.25]) compared with other HNC populations (mucosal/salivary HNC). Consistently, physician focus group noted that patients with thyroid cancer were particularly suited for telemedicine because of less emphasis on in-person examinations. Physicians also underscored factors that influence telemedicine use, including clinical suitability (treatment status, visit purpose, examination necessity), patient benefits (travel time, access), and barriers (technology, rapport-building). CONCLUSION: Patient experience with telemedicine is diverse among the HNC population. Notably, patients with thyroid cancer had overall better experience and were identified to be more appropriate for telemedicine compared with other patients with HNC. Future research that optimizes patient experience and selection is needed to ensure successful integration of telemedicine into routine oncology practice.
Keywords: adult; aged; middle aged; patient satisfaction; psychology; questionnaire; physicians; head and neck neoplasms; physician; therapy; head and neck tumor; telemedicine; humans; human; male; female; surveys and questionnaires
Journal Title: JCO Oncology Practice
Volume: 20
Issue: 8
ISSN: 2688-1527
Publisher: American Society of Clinical Oncology  
Date Published: 2024-08-01
Start Page: 1091
End Page: 1102
Language: English
DOI: 10.1200/op.23.00608
PUBMED: 38684040
PROVIDER: scopus
PMCID: PMC11615655
DOI/URL:
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF; MSK corresponding author is Tony K.W. Hung -- Source: Scopus
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MSK Authors
  1. Yuelin Li
    219 Li
  2. David G Pfister
    389 Pfister
  3. Erin Faye Gillespie
    149 Gillespie
  4. Tony K.W. Hung
    32 Hung