Telehealth saves patients with cancer time and money
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Telehealth oncology services saved patients with cancer time, travel and money, according to study results published in JAMA Network Open.
The findings suggest expansion of telehealth services could effectively reduce financial burdens among those with cancer, researchers concluded.
Rationale and methods
As the cost of cancer care continues to increase, patients undergoing cancer treatment face significant stress, Krupal B. Patel, MD, MSc, FRCS(C), assistant member in the department of head and neck-endocrine oncology at Moffitt Cancer Center, told Healio.
“Financial toxicity is now becoming an important topic in cancer care delivery and includes both objective financial burden and subjective financial distress,” Patel said. “Patients need to think about getting back and forth to the treatment site, time off from work, loss in income and loss of employment. With the COVID-19 pandemic, there was a substantial increase in telemedicine, driven by the need to give patients access to timely and high-quality care. Moffitt Cancer Center established a department of virtual medicine and experienced an increase of 5,000% in virtual visits in response to COVID-19.”
As restrictions from the pandemic eased, there were discussions at the CMS level to reconsider reimbursement for telehealth services, Patel added.
“We clinicians were hearing from our patients that this was a time and money saver for our patients and their caregivers,” he said. “Our patients come from all over Florida, nationally and internationally. We wanted to continue to offer this as part of an integrated cancer care delivery. To objectively prove cost savings, we decided to assess costs of travel and potential loss of productivity due to the medical visit.”
Patel and colleagues analyzed 25,496 telehealth visits (61.4% women; 72% Hispanic) for cancer care among 11,688 patients (median age, 55 years) who completed the visits between April 1, 2020, and June 30, 2021.
Estimated patient cost savings from telehealth services, including cost of travel and potential loss of productivity due to medical visits, served as main outcomes. Researchers used two different models with combined mileage rates of $0.56/mile and $0.82/mile and census tract-level median hourly wages.
Results
Researchers identified 4,525 new or established visits among 3,795 patients and 20,971 follow-up visits among 10,049 patients.
Results showed overall estimated mean total cost savings ranged between $147.40 ($120.10) at $0.56/mile and $186.10 ($156.90) at $0.82/mile.
Among those with new or established visits, mean total cost savings per visit ranged between $176.60 ($136.30) at $0.56/mile and $222.80 ($177.40) at $0.82/mile. Mean total cost savings per follow-up visit ranged between $141.10 ($115.30) at $0.56/mile and $178.10 ($150.90) at $0.82/mile.
Limitations included the study being conducted at a tertiary/quaternary referral center, so roundtrip travel distances may be higher than usual, and the assumed employment rates and incomes of patients aged younger than 65 years may vary, according to researchers.
Implications
“The team at Moffitt Cancer Center is undertaking numerous initiatives to support the growth of telehealth, including support for the department of virtual medicine, streamlining schedules and scheduling process, active technical support for patients and clinicians to ensure troubleshooting in real time, and integrating interpreter services for non-English speaking patients and clinicians,” Patel said. “Telehealth has the potential to deliver care from a distance, but we need to ensure that this is of high quality and the study team is undertaking projects to assess this important topic. Telehealth has the potential to decrease disparities in care delivery, if access to technology is equitable.”
For more information:
Krupal B. Patel, MD, MSc, FRCS(C), can be reached at krupal.patel@moffitt.org.
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