Rapid First Contact Using Virtual Visits to Improve Time-To-Treatment for Uterine Cancer

Study Overview
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Brief Summary
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This project aims to evaluate whether rapid first contact with the oncologist the same day or the next day after pathologic diagnosis contributes to a decreased time to treatment, decreased patient anxiety and increased patient satisfaction.

Detailed Description
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Time to treatment (time from disease diagnosis to initiation of treatment) impacts outcomes in uterine cancer. When controlled for stage, patients with longer time to treatment tend to have less favorable outcomes. Similarly, longer time to treatment has a negative impact on patients' quality of life and markers for anxiety. Our experience at this institution suggests that the time to referral (time from uterine cancer diagnosis and the patients' first encounter with the oncologist) is variable and presents the greatest opportunity for decreasing time to treatment. Among the factors that contribute to the time to referral are the time taken by the referring provider to relay the diagnosis to the patient, time taken to schedule an appointment with the specialist, and the patient's availability to keep an appointment. Virtual visits provide an opportunity to expedite consultation with the treating oncologist by removing some of the barriers that delay face-to-face visits. Among these barriers are patients' availability for a short notice face-to-face visit based on their work or family obligations, access to transportation, and mental preparedness.

Official Title
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Rapid First Contact Using Virtual Visits to Improve Time-To-Treatment for Patients With Uterine Cancer

Conditions
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Uterine Cancer

Intervention / Treatment
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* Behavioral: Virtual visit
* Behavioral: Office visit


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Uterine cancer diagnosis on biopsy read by Cleveland Clinic Pathology Department Patients must be willing to participate in a virtual visit as the initial meeting with an oncologist at the Cleveland Clinic. Receive care at Fairview Hospital, Hillcrest Hospital or Cleveland Clinic Main Campus Internet connected smartphone or internet connected computer with webcam Participants must have email access English speaking Competent to make clinic decisions Exclusion Criteria: No diagnosis of uterine cancer

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Rapid first contact virtual visit<br>Subjects will accept the offer of a virtual visit after being contacted by the nurse to offer a virtual visit with the oncologist prior to the in person office visit once a diagnosis has been confirmed. Subjects will be randomized after accepting offer of a virtual visit. | Behavioral: Virtual visit<br>* Virtual visit with oncologist following uterine cancer diagnosis prior to scheduled office visit.<br>|
| Placebo Comparator: First contact in person office visit<br>Subjects will accept the offer of a virtual visit after being contacted by the nurse to offer a virtual visit with the oncologist prior to the in person office visit once a diagnosis has been confirmed. Subjects will be randomized after accepting offer of a virtual visit. | Behavioral: Office visit<br>* Scheduled office visit with oncologist following uterine cancer diagnosis.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to treatment following diagnosis to treatment initiation | How long between diagnosis to treatment | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Amount of anxiety demonstrated when virtual visits are added | Level of anxiety using GAD-7 | 30 days | 
| Number of patients willing to pay for a virtual visit | Assess patients valuation of virtual visits by measuring their willingness to pay | 30 days | 
| Number of patients with improved satisfaction scores | Determine whether the addition of a rapid virtual visit improves patients satisfaction | 30 days |