Patient Perceptions Around Quality of Care Through Telemedicine in Neuro-Oncology

Study Overview
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Brief Summary
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This study evaluates patient perceptions around quality of care through telemedicine in neuro-oncology. Studying questionnaires related to perceptions quality of care through telemedicine in patients with brain cancer may help doctors to improve the delivery of care through this modality.

Detailed Description
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PRIMARY OBJECTIVE: I. To evaluate the patient-perceived quality of care by group (telemedicine versus in-person visits) in patients with central nervous system (CNS) cancer. SECONDARY OBJECTIVES: I. To characterize the visits provided by telemedicine compared to those in-person. II. To contrast the average time spent on telemedicine visits compared to in-person visits, and the delay between visit order placement and visit occurring. III. To evaluate the domains of patient care addressed on a telemedicine visit versus in-person visit per documentation, including (1) treatment planning, (2) symptom burden, (3) goals of care. IV. To evaluate frequency of acute care sought (through emergency room or urgent care clinic) within 30 days of encounter in telemedicine visit versus (vs) in-person visit. V. The impact of patient and clinical characteristics on perceived quality of care in the context of covariate-adjusted modeling. OUTLINE: Patients complete a survey related to their perceived quality of care via telephone and have their medical chart reviewed prospectively.

Official Title
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Patient Perceptions Around Quality of Care Through Telemedicine in Neuro-Oncology

Conditions
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Central Nervous System Neoplasm, Leptomeningeal Neoplasm, Metastatic Malignant Neoplasm in the Brain, Primary Brain Neoplasm

Intervention / Treatment
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* Other: Electronic Health Record Review
* Other: Survey Administration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with a CNS tumors: this includes patients with primary brain tumors, brain metastases, and leptomeningeal disease Established patients with a follow up encounter with Neuro-Oncology at the Brain and Spine Center at the University of Texas MD Anderson Cancer Center; this encounter can be An in-person visit A telemedicine appointment Exclusion Criteria: Encounter occurred with the assistance of official language translation support Patients with telephone encounters (without interactive video) New patient or consult visits Neither patient nor caregiver present during the visit are available or able to answer survey questions

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Observational (survey, medical chart review)<br>Patients complete a survey related to their perceived quality of care via telephone and have their medical chart reviewed prospectively. | Other: Electronic Health Record Review<br>* Review of medical chart<br>Other: Survey Administration<br>* Complete survey<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survey response to question 6 of the quality of care survey (I felt I received good medical care during this encounter) | Survey responses will be summarized by ordinal category as counts with percentages, separately by group. Will separately estimate the proportion of each ordinal level of each group with 95% confidence interval. | through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of Care Survey | Will separately estimate the proportion of each ordinal level of each group with 95% confidence interval. | through study completion, an average of 1 year | 
| Patients and clinical characteristics | Differences between groups will be assessed by 2-sample 2-sided t-test and Mann-Whitney test, Fisher's exact test, or chi-square test. | Baseline | 
| Interactive time spent during visit | Will be summarized by group per mean, median, standard deviation, and range. Differences between groups will be assessed by t-test and Mann-Whitney test. | through study completion, an average of 1 year | 
| Time from visit order placement to visit occurring | Will be summarized by group per mean, median, standard deviation, and range. Differences between groups will be assessed by t-test and Mann-Whitney test. | through study completion, an average of 1 year | 
| Domains of patient care addressed during a visit, including treatment planning, symptom burden, and goals of care | Will be summarized as counts with percentages by group. Differences between groups will be assessed by chi-square test. | through study completion, an average of 1 year | 
| Incidence of acute care sought (through emergency room or urgent care clinic) | Will be summarized as counts with percentages by group. Differences between groups will be provisionally assessed by Fisher's exact test. | Within 30 days of encounter |