Radiation Oncology Provider Telehealth Satisfaction: Survey Results From a Single NCI-Designated Institution.

Abstract

PURPOSE/OBJECTIVE(S)\nTelehealth (TH) for radiation oncology services has emerged as a new modality for care delivery and will likely persist beyond the COVID pandemic. Data regarding radiation oncology provider satisfaction of TH are limited and essential to the sustainable adoption of this tool.\n\n\nMATERIALS/METHODS\nAn anonymous electronic survey assessing TH experience was distributed in 11/2020 to all clinical radiation oncology physicians and APPs at a single large NCI-designated institution, including affiliate clinics. Those who utilized TH (phone or video) were invited to participate. The provider survey was designed using the technology-acceptance model (TAM), a validated method to predict use and acceptance of technology tools. Survey items included 4 assessing provider role, 1 regarding TH utilization, 26 assessing TH experience on a 5-point Likert scale, and 1 free response assessing current barriers to TH. Percent satisfaction is reported as the percentage of top 2 positive or affirmative responses on the Likert scale as a proportion of all responses.\n\n\nRESULTS\n19 of 34 radiation oncology providers (56%) completed the survey, including 15 attending physicians and 4 APPs. Providers specialized in central nervous system (n\u202f=\u202f3), head and neck (n\u202f=\u202f2), gastrointestinal (n\u202f=\u202f1), breast (n\u202f=\u202f2), genitourinary (n\u202f=\u202f4), gynecological (n\u202f=\u202f2), sarcoma (n\u202f=\u202f1), and general oncology (n\u202f=\u202f4). Providers reported having 1-10 (n\u202f=\u202f5), 11-15 (n\u202f=\u202f7), or > 20 years (n\u202f=\u202f7) in practice. Providers utilized TH for on-treatment visits (53%), follow-ups (86%), and consults (79%). 56% of providers enjoyed experimenting with new technology and 61% felt that technological advances improved care for patients. Regarding aspects of the TH clinical encounter: providers had high satisfaction with ability to document the visit (89%), obtaining patient history (83%), and ease of discussing radiation treatment decisions (71%). There was lower satisfaction with ability to create rapport (33%), ease of obtaining consent for radiation (33%), and ease of evaluating physical exam findings (19%). Regarding workflow: 39% felt that TH was compatible with existing oncology clinical workflow, 39% felt TH gave them greater control over work, 33% providers felt that TH improved their job efficiency, and 28% felt TH made them more productive. Regarding ease of TH use: 44% felt that interacting with TH services was frustrating and 39% felt that TH services did not require much training. 24% felt the TH adequately replaced face to face visits. Providers identified the following barriers to TH implementation: lack of MA/RN/APP support, interruptions to TH visits by treatment/simulation clinical duties, lack of dedicated TH template, and burden of navigating the electronic medical record.\n\n\nCONCLUSION\nRadiation oncology providers at our institution expressed mixed satisfaction to incorporating TH into their practice. Current strategies to address barriers, including implementation of a telehealth care coordinator, are underway.