Abstract PO-101: Patient experiences and opinions using teleoncology in a safety-net hospital during the COVID-19 pandemic
Authors: Wiele Andrew , Patel Tejal A. , Rizvi Sarah , De Los Rios Patricia , Russo Kristyn-Mae , Smith Demetria , Hester Robert , Ma Hilary Y. , Rieber Alyssa 
Published: December 2020

Background: In response to the COVID-19 pandemic, telehealth has emerged as a key strategy to ensure the safety of patients and healthcare workers and minimize disease spread. Lyndon B. Johnson Hospital (LBJ) is a safety-net hospital that mainly serves low income and uninsured patients (pts), and MD Anderson Medical Oncology faculty and fellows diagnose and treat over 800 new cancer cases per year in the LBJ Oncology Clinic. We piloted a teleoncology (TO) program to replace in-person visits for pts with clinic appointments (appts) during the COVID-19 pandemic. Methods: A multidisciplinary team was formed to implement TO in the LBJ Oncology Clinic.

Fellows and APPs screened their appts in advance and used guidelines to determine pts appropriate for TO. Clinic visits were prioritized for new pts, treatment consents, and symptomatic pts; stable pts on treatment and surveillance were changed to TO. Pts were notified when their appts were converted, and integrated video visits were preferred over telephone visits. Demographic data was collected and a pt satisfaction survey was distributed, in English or Spanish, via email to patients that participated during the initial 1-month pilot period. Results: From 4/13/2020 – 5/8/2020, we identified 251 pts that utilized TO and distributed the survey to 236 pts; 15 pts did not have an email address on file. Median age was 57 years (range, 20-88) and 66% were female; 63% were Hispanic and 21% were African American; 52% spoke Spanish and 46% spoke English. 57% of TO visits were conducted via telephone and 43% via video. Survey response rate was 43.2% (102/236); 54.9% responded in English and 45.1% responded in Spanish. 78.6% of pts that answered the survey were female and 65.6% were Hispanic. 71.6% of pts that answered the survey participated in video visits, 20.6% of pts were unable to participate in video visits, and 7.8% did not answer the question. The most common reasons pts did not participate in video visits were that they lacked proper technology (47.6%) or preferred discussing their care via telephone (33.3%). 66.7% of pts felt safer (agree/strongly agree) and 75.5% felt less stressed (agree/strongly agree) participating in TO visits instead of traveling to LBJ for in-person visits. 88.2% of pts would regularly consider TO instead of in-person visits in the future (sometimes/usually/always). Conclusions: This study demonstrates that oncology patients in a safety-net hospital responded favorably to TO. Importantly, pts felt safer and less stressed participating in TO, and nearly all patients would regularly consider TO in the future. Most of the pts that answered the survey participated in video visits, but less than half of all the TO visits were conducted via video during this pilot period, suggestive of a selection bias. Because the survey was distributed via email, the technological barriers may be more significant than observed in this study and its social determinants are currently being explored.

Citation Format: Andrew Wiele, Tejal A. Patel, Sarah Rizvi, Patricia De Los Rios, Kristyn-Mae Russo, Demetria Smith, Robert Hester, Hilary Y. Ma, Alyssa Rieber. Patient experiences and opinions using teleoncology in a safety-net hospital during the COVID-19 pandemic [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-101.