(UroToday.com) The recent COVID-19 pandemic has emphasized the importance of remote interactions, as facilitated through telemedicine. However, there is a pre-existing need for remote care delivery. In a session of the Best Poster Presentations in Health Services and Other Research at this year's Society of Urologic Oncology (SUO) virtual annual meeting, Dr. Gadzinski pointed out that nearly one-fifth of all Americans live in rural communities and experience significant barriers to accessing specialized cancer care, including the distance required to travel. Notably, he highlighted that 60% of all counties, and approximately 47 million Americans, do not have a urologist geographically available.
Dr. Gadzinski described the effect of a rurally focused telemedicine program in urologic oncology. These authors prospectively identified patients residing in rural regions of Washington state, or outside of Washington, with a known or suspected urological cancer who were evaluated at the University of Washington through either in-person clinic visits or telemedicine interactions. Following their visit, patients were invited to complete post-visit surveys assessing satisfaction, travel time, cost, and work absenteeism. In this analysis, the authors compared responses among patients who were seen in-person as compared to those who were seen via telemedicine.
Among 1453 eligible patients seen between August 2019 and July 2020, 615 (42%) completed the survey. Of these 198 had in-person visits and 417 had telemedicine visits. There was a dramatic increase in the use of telemedicine in March and April 2020.
The median age of included patients was 68 years, the vast majority were men (89%) and white (73%). The majority of patients were from Washington state (525, 85%). The reason for consultation was prostate cancer in 62%, kidney cancer in 14%, urothelial cancer in 22%, and testis cancer in 2%. Telemedicine visits were associated with significantly lower travel time, travel distance, travel cost, use of air travel, the requirement of a hotel stay, and days off work, as highlighted in the table below.
Notably, 11% of patients coming for in-person visits had associated costs exceeding $1000. There were no differences in patient satisfaction.
The authors conclude that telemedicine offers a medium for cancer care delivery which reduces travel burden and cost. Moving forward, Dr. Gadzinski postulated that telemedicine may have an impact on individual cancer outcomes, and potentially the outcomes for rural and underserved populations.
Presented by: Adam J. Gadzinski, MD, MS, Acting Instructor of Urologic Oncology at the Urology Clinic at the University of Washington, Seattle Washington, UWMC.
Written by: Christopher J.D. Wallis, MD, Ph.D., Instructor in Urology, Vanderbilt University Medical Center, Nashville, Tennessee @WallisCJD on Twitter at the 2020 Society of Urologic Oncology Annual Meeting – December 2-5, 2020 – Washington, DC