Telemedicine Visit Type and Patient Satisfaction and Costs Among Patients With Urologic Cancer

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: US states eased licensing restrictions on telemedicine during the COVID-19 pandemic allowing broad use irrespective of visit type. As waivers expire, optimal uses of telemedicine must be assessed to inform policy, legislation, and clinical care. We assessed whether telemedicine visits provided the same patient experience as in-person visits, stratified by whether these were new or established patient visits, and examined the financial burden. METHODS: Patients from the WWAMI region (including Oregon and Hawaii, but excluding Wyoming) seen in person and via telemedicine for urologic cancer care at a major regional cancer center received a survey after their first appointment (August 2019eJune 2022) on satisfaction with care, perceptions of communication during their visit, travel time, travel costs, and days of work missed. We assessed patient-reported outcomes after their visit with descriptive statistics. RESULTS: Surveys were completed for 1,031 patient visits (N[494 new patient visits, N[537 established patient visits). Satisfaction rates were high for all visit types, both new and established (mean score 59.9e60.7 [maximum 63], p>0.05). There was no difference in patient-rated quality of the encounter across visit type and modality (in-person vs. telemedicine, p>0.06 for nearly all comparisons). Patients presenting for telemedicine visits were more likely to believe that visits could be accomplished without physical exam, regardless of visit type (p<0.02). New in-person patient visits were associated with significantly higher travel costs (mean estimated visit costs $496.10, SD $1021) compared with new telemedicine visits (mean costs $26.70, SD $141 - p<0.001); 27% of patients receiving new in-person care required plane travel and 41% required a hotel stay (p<0.001 compared with 0.8% and 3.2% of new telemedicine patients, respectively). CONCLUSIONS: Telemedicine appointments may increase access for rural-residing patients with cancer. Satisfaction outcomes among patients with urologic cancer receiving new patient telemedicine care equaled those of new patients cared for in-person; costs were markedly lower. Extending telemedicine exemptions beyond COVID-19 licensing waivers to include new patient visits would permit continued delivery of high-quality urologic cancer care to rural-residing patients. A notable limitation of this study is the large geographic breadth of the cancer center catchment compared with other areas of the US, possible limiting generalizability.

Volume

211

Issue

5S

First Page

e173

Comments

American Urological Association Annual Meeting, May 3-6, 2024, San Antonio, TX

DOI

10.1097/01.JU.0001008576.33217.96.01

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