Dr. Daniel Carson on telehealth vs in-person urology visits

In this video, Daniel Carson, MD, MS, discusses the background and notable findings from the Urologic Oncology paper, “Telehealth visit type and patient-reported outcomes among patients with cancer.” Carson is a urology resident at the University of Washington in Seattle.

Transcription:

Please describe the background for this study.

The title of our study is "Telehealth visit type and patient-reported outcomes among patients with cancer," and the focus was really to evaluate patient satisfaction and appointment-related costs with telehealth or in-person visit stratified by new or established encounters. We know that telehealth as a health care delivery modality has numerous benefits, including its ability to overcome geographic barriers to care. Despite this, pre-COVID, there had been limited progress and broad implementation of these services. However, in response to the COVID-19 pandemic and the related emergency licensure waivers, we saw a dramatic rise in the use of telehealth by the end of 2020, but unfortunately, with the expiration of these emergency waivers, many of those pre-COVID legal restrictions on telehealth care resumed, and we've seen significant state-to-state variability in terms of its application, and several of those states that have incorporated licensure waivers beyond the COVID-19 pandemic have limited its use to establish patient visits only. As such, our study was meant to look at a prospective patient cohort and compare patient-reported outcomes between in-person and telehealth visits for both new and established visit encounters.

What were some of the notable findings?

There were 2 main findings from our study. The first was that patient-reported satisfaction scores were high for both telehealth and inpatient visits for both new and established encounters. And second, we found that in-person visits incurred significantly higher costs and travel burden compared with telehealth visits for both new and established encounters. This was particularly magnified for our new-patient cohort. For example, the mean reported total cost related to new in-person visits was about $500 compared with about $25 for new telehealth visits. For new in-person visits, 27% of our patients required plane travel, and 41% required a hotel stay. That's compared with less than 1% or 3% for our new telehealth visits for those respective items. Finally, about half of our patients convening new in-person visits had to miss at least a half day at work, and that was compared to about 11% for our new telehealth visits. Intuitively, these results are not necessarily surprising to us, but data to this end are certainly important to share when we're advocating for policy change to broaden the application of telehealth services.

This transcript was edited for clarity.