3676 - Peri-Pandemic Trends in Radiation Oncology Telehealth Utilization at a Major Academic Center: Implications for Access, Treatment, and Practice
Presenter(s)
A. R. Mahal1,2, A. Murray1, N. E. Martin1, K. Y. Shin3, Y. H. Chen3, and S. Tanguturi1; 1Department of Radiation Oncology, Brigham and Women’s Hospital/Dana-Farber Cancer Institute, Boston, MA, 2Department of Radiation Oncology, University of Miami Sylvester Cancer Center, Miami, FL, 3Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
Purpose/Objective(s): The COVID-19 pandemic accelerated telehealth adoption in radiation oncology (RO), prompting regulatory changes that expanded virtual visit (VV) use. This study evaluates VV utilization trends across peri-pandemic periods at an NCI-designated academic medical cancer center (AMCC) and 4 integrated network sites, identifying patient populations best suited for VV and assessing treatment conversion rates (TCr).
Materials/Methods: A retrospective cohort study analyzed 41,091 new patient encounters (PtEnc) from 1/1/18-10/24/23, with 25,408 linked to radiation treatment. Data were examined across four peri-pandemic periods: pre-pandemic, state of emergency (3/17/20-6/15/21), new normality (6/16/21-3/5/22), and post-pandemic, based on key policy changes. Consultation and TCr were assessed by patient demographics, disease site, visit type (VV vs in-person), and location (AMCC vs network sites). Logistic regression in R 4.4.0 evaluated associations between visit type and patient factors.
Results: Telehealth use surged during the pandemic and remained elevated post-pandemic, particularly at the AMCC (~20% of consultations). While breast and GU cancers had the highest consultation volume, CNS had the highest likelihood of VV (adjusted odds ratio [AOR] 2.67, 95% CI 2.24-3.17, p<0.01), followed by secondary metastatic disease (AOR 2.19, 95% CI 1.87-2.57, p<0.01). TCr following VV were comparable to in-person visits (overall: OR 1.07, 95% CI 1.02-1.23, p=0.01; post-pandemic: OR 1.01, 95% CI 0.92-1.12, p=0.8), though patients living farther from the AMCC were more likely to receive care locally (p<0.01). Despite reduced VV use post-pandemic (AOR 0.11, 95% CI 0.09-0.15, p<0.01), network sites had higher TCr than the AMCC (AOR 1.80, 95% CI 1.55-2.10, p<0.01). Subsequent PtEnc increased VV likelihood at those visits (p<0.01). Disparities were observed, with lower VV engagement among non-English-speaking and Hispanic patients.
Conclusion: Telehealth remains integral to RO, with sustained VV use post-pandemic. CNS and metastatic cancers appear suited for VV, though utilization varies by center. AMCC and network site differences in VV use and TCr may reflect patient proximity, clinical trial access, and practice specialization. Despite these variations, comparable TCr suggest that telehealth preserves access to RO treatment while also enabling local care delivery for patients living at great distances. Ongoing policy efforts should sustain reimbursement parity, reduce digital health disparities, and streamline interstate licensure. Further research is needed to refine patient selection and optimize hybrid care models in RO.