Telemedicine and urologic cancer: multidisciplinary clinics expand access and deliver positive patient experience

Telemedicine multidisciplinary urologic cancer clinics implemented by the University of Washington/Seattle Cancer Care Alliance to expand healthcare access during the COVID-19 pandemic achieved a high level of patient satisfaction.¹

The clinics delivered a positive patient experience by sparing substantial travel burden, while still delivering the high-quality care patients were accustomed to from their previous in-person medical visits, according to a poster presented during the 2020 Society of Urologic Oncology’s Annual Meeting.

“We rapidly implemented a telemedicine Multidisciplinary Urologic Cancer Clinic (MDUCC) at the University of Washington/Seattle Cancer Care Alliance in order to reduce the risk of COVID-19 transmission while providing multidisciplinary cancer care. We aim to report our experience and assess patient-reported outcomes from our telemedicine MDUCC,” wrote the researchers, adding that this could improve access to multidisciplinary urologic cancer care.

The telemedicine multidisciplinary clinics consist of video visits with a urologic oncologist, medical oncologist, and radiation oncologist. Video visits were conducted in the same format as in-person visits would have been prior to the pandemic. In addition, tumor boards that included radiologists and pathologists were conducted using video conferences.

Following the video visits, patients were invited to complete a survey to assess satisfaction, provider trust, travel time, and costs related to the visit. In the survey, 1 equated to strongly agree, while 7 equated to strongly disagree.

To assess patient-reported outcomes from the telemedicine MDUCC, the researchers prospectively collected patient demographic and oncological data, and estimated travel distances and times from each patient’s home to the MDUCC.

From March to June 2020, the researchers conducted 23 video visits, including 21 patients who took the visit from home and 2 who traveled to a nearby area for broadband access. Median age was 69 years. The majority of patients were male (87%) and white (61%). Patients presented with bladder (n = 18), kidney (n = 3), upper tract urothelial carcinoma (n = 1), and penile cancer (n = 1). Seventy percent of patients had stage III or IV disease.

In total, 12 patients (52%) responded to the post-visit survey.

The majority of patients reported they strongly agreed with the following questions:

• I was pleased with the quality of the medical encounter (n = 9; 75%)
• My visit was on-time and efficient (n = 5; 50%)
• I believe that the medical encounter was conducted in a confidential manner (n = 9; 75%)
• I was able to share sensitive and/or personal information provided (n = 8; 67%)
• I was pleased with the quality of educational information provided (n = 7; 58%)
• I was overall satisfied with my appointment (n = 9; 75%)
• I believe the provider is able to do his or her job, even if they aren’t able to conduct a physical examination at every appointment (n = 5; 42%)
• I have a trusting relationship with my provider (n = 4; 33%)
• Considering the cost and time commitment of my appointment, I would choose to meet with my provider in this setting in the future (n = 8; 67%)

All 12 patients responded that they would be willing to have future appointments via telemedicine.

The median travel costs, time, and distance reported were each 0. The researchers estimated that telemedicine saved patients a median 1-way travel distance of 52 miles (IQR, 16-127) and 1-way travel time of 71 minutes (IQR, 42-147).

“Telemedicine multidisciplinary clinics are feasible and effective in providing access to multidisciplinary urologic cancer care,” the researchers concluded. “Patient satisfaction was high and many patients were spared a substantial travel burden. Telemedicine may be leveraged during and after COVID-19 to improve access to multidisciplinary urologic cancer care.”

Reference

1. Gadzinski AJ, Sekar RR, Abarro IO, et al. Telemedicine multidisciplinary urologic cancer clinics during COVID-19. Presented at: Society of Urologic Oncology 21st Annual Meeting; December 3, 2020. Poster 10.