Telehealth use and acceptability amongst a diverse oncology patient population.
Authors: Michel Alissa M. , Lichtenstein Morgan RL , Faheem Khadija , Harden Erik , Hillyer Grace , Beauchemin Melissa P. , Accordino Melissa Kate , Hershman Dawn L. 
Published: September 2024

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Background:
Existing research describes numerous barriers to care for patients with cancer, including time constraints, cost, and additional health conditions. We sought to assess telehealth access and experience amongst a diverse patient population at an academic medical center.
Methods:
We administered a 60-question, cross-sectional, in-person survey to adult patients with a diagnosis of solid tumor or hematological malignancy on active treatment at Columbia University Irving Medical Center (CUIMC) in New York, NY between January 2023 and February 2024. The survey assessed access to and attitudes, beliefs and experience with telehealth as part of routine care and clinical trials. Demographics including age, gender, race/ethnicity, marital status, income, insurance type and education were self-reported.
Results:
The survey was administered to 100 patients with cancer (breast cancer, n=25; gastrointestinal cancer, n=25; genitourinary cancer n=25; and hematologic malignancy, n=25); 37% were actively enrolled or previously enrolled on a clinical trial. The mean age was 61 years; 51% were female; 45% non-White, and 23% Hispanic. The majority (63%) reported traveling >30 min to their treatment, with 48% reporting travel costs >$20 per visit. Six percent reported difficulty receiving treatment due to cost, and 23% reported difficulty getting to visits due to other conditions or disabilities. The majority (87%) reported having access to a computer or electronic device; 99% of those had internet access and 81% were comfortable using the internet. Of those who had prior video visits (59%), almost all (97%) reported that video visits addressed their issues/questions well. About a quarter of the patients who had not had a video visit reported that they would prefer to have video visits about a cancer-related issue rather than going into the office. For those who preferred a video visit (n=18), top reasons included elimination of travel, convenience, and not feeling rushed. Top barriers among those who expressed hesitance (n=23) included lack of access to necessary technology, not knowing how to use the technology, concern about getting the same level of care, or preference for in-person communication. Similar to video visits, 52% participants reported that they had a scheduled telephone visit with their oncologist instead of going to the office; 98% reported that their issues were either somewhat or very well addressed.
Conclusions:
In this cross-sectional study amongst a racially, ethnically and socioeconomically diverse population, we found that most patients with cancer on active treatment had access to telehealth and were satisfied with telehealth visits. Those who had not utilized telehealth were interested given convenience and elimination of travel. We found minimal barriers to telehealth access in this diverse urban population. Telehealth may offer an adjunct to reduce financial and logistic barriers to cancer care.