Cancer patient safety, satisfaction high with virtual radiation care

Radiation oncology treatment provided via telehealth is associated with high patient satisfaction and safety and substantial cost savings, according to research published in JAMA Network Open.

The study assessed Memorial Sloan Kettering Cancer Center’s remote radiation care model, which was implemented during the COVID-19 pandemic. However, the study authors noted that the safety and satisfaction of patients receiving care through the model are unclear.

Thus, the Memorial Sloan Kettering researchers set out to examine not only patient safety and satisfaction linked to the remote care model but also financial implications and environmental consequences.

They conducted a retrospective cohort study with patients receiving radiation treatment who opted for fully remote management between October 1, 2020, and October 31, 2022. They collected data on patient safety events with an in-house quality improvement reporting system and assessed patient satisfaction through electronic surveys. The study included 2,817 patients, of which 38.9 percent had metastatic disease.

The remote care model included an initial in-office or telehealth consultation, after which patients received daily radiation treatment at a network site close to their homes. The treating physician prescribed the treatment, designed the treatment plan, and conducted weekly management visits with the patient via telehealth.

Researchers found that though 764 adverse patient safety events were reported, 763 (99.9 percent) did not reach patients or caused no harm to patients. The events were largely related to treatment planning issues (42.2 percent), treatment planning procedure or treatment delivery delay (11.8 percent), and scheduling errors (10.7 percent).

Further, researchers observed high patient satisfaction, with 97.6 percent of the 873 survey respondents rating satisfaction as good or very good across all domains. Most respondents (87.8 percent) either preferred telehealth or expressed no preference for in-person versus fully remote visits.

The study also showed that receiving radiation treatment at sites in New York or New Jersey rather than at the Manhattan campus saved patients 434,530 miles of driving distance. Regional campus treatment was associated with a total cost savings of $612,912.71, with an average of $466.45 cost savings per patient.

Additionally, the decrease in travel distance reduced the carbon footprint by an estimated 174 metric tons of carbon dioxide.

“These findings suggest that the planned continuation of the program will allow for preservation of patient and clinician flexibility, expanded access, and decreased financial toxicity among properly selected patients,” the researchers concluded.

The study aligns with previous research about how telehealth can enhance cancer care.

For instance, a study published in May 2023 revealed that telehealth-based cancer care was linked to higher rates of patient satisfaction with access and provider concern compared to in-person encounters.

The survey conducted by Moffitt Cancer Center polled 39,268 patients who participated in over 50,000 visits from April 1, 2020, to June 30, 2021.

More patients (75.8 percent) rated telehealth visits as highly satisfactory with regard to care access compared to in-person visits (62.5 percent). When asked about the extent to which their provider showed concern during their visit, patients rated 84.2 percent of in-person visits and 90.7 percent of telehealth visits as highly satisfactory.

Another study published in 2023 shows that telehealth-based oncology services helped reduce travel-related challenges among non-elderly cancer patients.

The researchers conducted an economic evaluation of cost savings related to completed telehealth visits from April 1, 2020, to June 30, 2021, at a single National Cancer Institute-designated comprehensive cancer center. Researchers defined non-elderly as those between 18 and 65 years. The study population included 11,688 patients who participated in 25,486 telehealth visits.

The study's cost models show that the estimated mean total cost savings ranged from $147.4 at $0.56 per mile to $186.1 at $0.82 per mile. Based on these findings, researchers concluded that telehealth did help save patients time and travel costs.