Teleoncology for Veterans: High Patient Satisfaction Coupled With Positive Financial and Environmental Impacts.

Autor:	Jiang CY; Department of Internal Medicine, University of Michigan, Ann Arbor, MI., Strohbehn GW; Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, MI.; Lieutenant Colonel Charles S. Kettles VA Medical Center (VA Ann Arbor Health System), Ann Arbor, MI.; VA Center for Clinical Management and Research, Ann Arbor, MI., Dedinsky RM; Lieutenant Colonel Charles S. Kettles VA Medical Center (VA Ann Arbor Health System), Ann Arbor, MI., Raupp SM; Lieutenant Colonel Charles S. Kettles VA Medical Center (VA Ann Arbor Health System), Ann Arbor, MI., Pannecouk BM; Lieutenant Colonel Charles S. Kettles VA Medical Center (VA Ann Arbor Health System), Ann Arbor, MI., Yentz SE; Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, MI.; Lieutenant Colonel Charles S. Kettles VA Medical Center (VA Ann Arbor Health System), Ann Arbor, MI., Ramnath N; Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, MI.; Lieutenant Colonel Charles S. Kettles VA Medical Center (VA Ann Arbor Health System), Ann Arbor, MI.
Jazyk:	angličtina
Zdroj:	JCO oncology practice [JCO Oncol Pract] 2021 Sep; Vol. 17 (9), pp. e1362-e1374. Date of Electronic Publication: 2021 Aug 18.
DOI:	10.1200/OP.21.00317
Abstrakt:	Purpose: There was rapid adoption of teleoncology care in the Veterans Health Administration during the COVID-19 pandemic. One third of 9 million Veterans Health Administration enrolled Veterans live in rural areas. Although digital solutions can expand capacity, enhance care access, and reduce financial burden, they may also exacerbate rural-urban health disparities. Careful evaluation of patients' perceptions and policy tradeoffs are necessary to optimize teleoncology postpandemic. Methods: Patients with ≥ 1 teleoncology visit with medical, surgical, or radiation oncology between March 2020 and June 2020 were identified retrospectively. Validated, Likert-type survey assessing patient satisfaction was developed. Follow-up survey was conducted on patients with ≥ 1 teleoncology visit from August 2020 to January 2021. Travel distance, time, cost, and carbon dioxide emissions were calculated based on zip codes. Results: A hundred surveys were completed (response rate, 62%). Patients overall were satisfied with teleoncology (83% Agree or Strongly Agree) but felt less satisfied than in-person visits (47% Agree or Strongly Agree). Audiovisual component improved patient perception of involvement in care, ability to self-manage health or medical needs, and comparability to in-person visits. Follow-up survey demonstrated similar satisfaction. Total travel-related savings are as follows: 86,470 miles, 84,374 minutes, $49,720 US dollars, and 35.5 metric tons of carbon dioxide. Conclusion: Veterans are broadly satisfied with teleoncology. Audiovisual capabilities are critical to satisfaction. This is challenging for rural populations with lack of technology access. Patients experienced financial and time savings, and society benefitted from reduced carbon emissions. Continued optimization is needed to enhance patient experience and address secondary effects. Competing Interests: Garth W. StrohbehnPatents, Royalties, Other Intellectual Property: Co-inventor of a filed patent held by the University of Chicago covering the use of low-dose tocilizumab in the treatment of viral infections Nithya RamnathResearch Funding: Merck, Clovis OncologyNo other potential conflicts of interest were reported.
Databáze:	MEDLINE
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