Efficiency and Safety of Telehealth vs In-Person Care for Patients With Cancer

A recent study comparing efficiency and safety outcomes among patients with cancer receiving telehealth care vs in-person care suggests that telehealth does not lead to worse efficiency or outcomes (JCO Oncol Pract. 2021; OP2100092. doi:10.1200/OP.21.00092).

The demand for telehealth has increased due to the COVID-19 pandemic. However, there have been no studies analyzing the utility and safety of telehealth among patients with cancer who are receiving systemic treatments.

“Concerns of the adequacy of virtual patient assessments for oncology patients include the risk and high acuity of illness and complications while on treatment,” wrote David Hsiehchen, MD, Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, and colleagues.

Dr Hsiehchen and colleagues examined data from newly referred patients who began systemic therapy, and mostly received care through telehealth between March and May of 2020, due to the COVID-19 pandemic, as well as 2016 newly referred patients from period in 2019 where there were only in-person visits. Metrics associated with clinical efficiency and treatment safety after propensity matching in participants were analyzed.

There were no significant differences between the in-patient care group and the telehealth group concerning patient-initiated telephone encounters that capture care or effort outside of visits, time to staging imaging, and time to therapy initiation.

The authors found no significant differences between the groups when it came to 3-month all-cause or cancer-specific emergency department presentations and hospitalizations, and treatment delays.

Virtual care saved an average of 211.4 minutes in travel time, per patient, over a 3-month interval.

“Our results indicate that replacement of in-person care with virtual care in oncology does not lead to worse efficiency or outcomes,” concluded the authors, adding, “Given the increased barriers to patients seeking oncology care during the pandemic, our study indicates that telehealth efforts may be safely intensified.”—Marta Rybczynski