Lessons learned: Telemedicine patterns and clinical application in patients with gynecologic cancers during COVID-19

Patient perspectives on perioperative telemedicine in female malignancies: the role of age, digital experience, and privacy concerns

BACKGROUND

Telemedicine offers new opportunities in perioperative care, particularly for patients with female malignancies. This study investigated factors influencing patient acceptance of telemedical services during the preoperative phase.

METHODS

Between May and November 2022, 145 patients with breast or gynecologic malignancies completed a structured questionnaire in a cross-sectional study during preoperative consultation. Sociodemographic factors, digital experience, and privacy concerns were assessed. Data were analyzed using descriptive statistics, t-tests, Chi-square, Mann-Whitney U-tests, and binary logistic regression.

RESULTS

Overall, 69% of patients expressed agreement with perioperative telemedicine. Younger age (mean 50.6 vs. 59.3 years; p = 0.001) and greater digital experience, especially video call usage (p = 0.005), significantly predicted approval. The most preferred modality was browser-based video consultation (47%; p = 0.007). No significant associations were found for distance to clinic (p = 0.672), EQ-VAS score (p = 0.597), or number of prior clinic visits (p = 0.331). Barriers included data protection concerns (p < 0.001) and discomfort with receiving sensitive information via telemedicine (p < 0.001).

CONCLUSION

Most patients view telemedicine as a valuable supplement to traditional care. Acceptance depends on age, digital literacy, and the perceived sensitivity of clinical communication. Tailored implementation respecting patient preferences is essential.

Telemedicine in geriatric oncology - lessons learned from the COVID-19 experience

PURPOSE OF REVIEW

Telemedicine quickly became integrated into healthcare caused by the Coronavirus 19 (COVID-19) pandemic. Rapid use of telemedicine into healthcare systems was supported by the World Health Organization and other prominent national organizations to reduce transmission of the virus while continuing to provide access to care. In this review, we explored the effect of this swift change in care and its impact on older adults with cancer.

RECENT FINDINGS

Older adults are susceptible to the COVID-19 virus caused by various risk factors, such as comorbidity, frailty, decreased immunity, and cancer increases vulnerability to infection, hospitalization, and mortality. We found three major themes emerged in the literature published in the past 18 months, including access to care, telemedicine modes of communication, and the use of technology by older adults with cancer. These findings have brought insight into issues regarding healthcare disparities.

SUMMARY

The utilization of telemedicine by older adults with cancer has potential future benefits with the integration of technology preparation prior to the patient's initial visit and addressing known health disparities. The hybrid model of care provides in-person and or remote access to clinicians which may allow older adults with cancer the flexibility needed to obtain quality cancer care.

An insight into the use of telemedicine technology for cancer patients during the Covid-19 pandemic: a scoping review

BACKGROUND

The use of telemedicine technology has significantly increased in recent years, particularly during the Covid-19 pandemic. This study aimed to investigate the use of telemedicine technology for cancer patients during the Covid-19 pandemic.

METHODS

This was a scoping review conducted in 2023. Various databases including PubMed, Web of Science, Scopus, Cochrane Library, Ovid, IEEE Xplore, ProQuest, Embase, and Google Scholar search engine were searched. All quantitative, qualitative, and mixed-method studies published in English between 2020 and 2022 were included. Finally, the needed data were extracted, and the results were synthesized and reported narratively.

RESULTS

A total of 29 articles were included in this review. The results showed that teleconsultation, televisit, and telerehabilitation were common telemedicine services, and video conferencing and telephone were common technologies used in these studies. In most cases, patients and healthcare providers preferred these services compared to the face-to-face consultations due to their convenience and advantages. Furthermore, the findings revealed that in terms of clinical outcomes, telemedicine could effectively reduce anxiety, pain, sleep disorders, and hospital admission rates.

CONCLUSION

The findings provided valuable insights into the various telemedicine technologies, services, users' perspectives, and clinical outcomes in cancer patients during the Covid-19 pandemic. Overall, the positive outcomes and users' satisfaction showed that the use of telemedicine technology can be expanded, particularly in cancer care. Future research needs to investigate both clinical and non-clinical effectiveness of using various telemedicine services and technologies for improving cancer care delivery, which can help to develop more successful strategies for implementing this technology.

In-Clinic versus Hybrid Cancer Rehabilitation Service Delivery during the COVID-19 Pandemic: An Outcome Comparison Study

Diminished health-related quality of life (HRQOL) is common among cancer survivors but often amendable to rehabilitation. However, few access real-world rehabilitation services. Hybrid delivery modes (using a combination of in-clinic and synchronous telehealth visits) became popular during the COVID-19 pandemic and offer a promising solution to improve access beyond the pandemic. However, it is unclear if hybrid delivery has the same impact on patient-reported outcomes and experiences as standard, in-clinic-only delivery. To fill this gap, we performed a retrospective, observational, comparative outcomes study of real-world electronic medical record (EMR) data collected by a national outpatient rehabilitation provider in 2020-2021. Of the cases meeting the inclusion criteria (N = 2611), 60 were seen to via hybrid delivery. The outcomes evaluated pre and post-rehabilitation included PROMIS® global physical health (GPH), global mental health (GMH), physical function (PF), and the ability to participate in social roles and activities (SRA). The patient experience outcomes included the Net Promoter Survey (NPS®) and the Select Medical Patient-Reported Experience Measure (SM-PREM). A linear and logistic regression was used to examine the between-group differences in the PROMIS and SM-PREM scores while controlling for covariates. The hybrid and in-clinic-only cases improved similarly in all PROMIS outcomes (all p < 0.05). The association between the delivery mode and the likelihood of achieving the minimal important change in the PROMIS outcomes was non-significant (all p > 0.05). No between-group differences were observed in the NPS or SM-PREM scores (all p > 0.05). Although more research is needed, this real-world evidence suggests that hybrid rehabilitation care may be equally beneficial for and acceptable to cancer survivors and supports calls to expand access to and reimbursement for telerehabilitation.