3697 - Telemedicine Trends in Radiation Oncology at Two Large Multi-Specialty Cancer Centers from 2019 to 2023
Presenter(s)
V. Parameswaran1, M. Miller2, J. Grimm3, R. Gullerud3, W. Fan3, D. Gibbons3, B. Oyarzabal3, J. Lunde3, J. Coffey3, S. Harper3, L. Rosengaus2, C. Sharp2, S. Shah4, E. L. Pollom5, T. Haddad3, B. Demaerschalk3, D. M. Routman6, W. Breen6, Y. Sharifzadeh7, and J. Pritchett3; 1Stanford University School of Medicine, Stanford, CA, 2Stanford Health Care, Stanford, CA, 3Mayo Clinic, Rochester, MN, 4Stanford Cancer Institute, Palo Alto, CA, 5Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, 6Department of Radiation Oncology, Mayo Clinic, Rochester, MN, 7Virginia Commonwealth University School of Medicine, Richmond, VA
Purpose/Objective(s): Many oncology practices have continued using telemedicine since the onset of the COVID-19 pandemic. However, the long-term sustainability of telemedicine in radiation oncology remains uncertain, particularly as federal policies that facilitated its adoption continue to evolve. Understanding similarities and differences in telemedicine utilization at high-volume oncology centers is essential for informing evidence-based policies that ensure access to oncology care across diverse geographic regions.
Materials/Methods: This multi-institution, cross-sectional, year-over-year retrospective cohort analysis examines trends in telemedicine (video or phone visit) utilization across all radiation oncology clinical appointments for adult patients (age >18) from January 2019 to December 2023 excluding the year 2020 due to pandemic related telemedicine surge. The study includes two large multispecialty cancer centers: one with multiple campuses in the California Bay Area referenced as Site one and another with a multiregional cancer practice featuring tertiary referral campuses in Minnesota, Florida, and Arizona, along with community-based clinics throughout the Upper Midwest referenced as Site two.
Results: Trends in telemedicine adoption were similar across both institutions, with an initial surge beginning in March 2020 facilitated by policy actions from the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services to expand access. While utilization remained stable from 2021 to 2023, the proportion of telemedicine use within overall practice differed between institutions. Telemedicine as a proportion of overall clinical practice was 51.8% (9115/17581) in 2021, 50.5% (9161/18128) in 2022, and 47.7% (9260/19428) in 2023 at Site one and 10.4% in 2021 (6811/65406), 13.7% in 2022 (9049/66138), and 15.5% in 2023 (10783/69657) at Site two. Deployment in the setting of new versus return visits also differed between institutions. In 2023, telemedicine accounted for 49.5% (2298/4646) of new and 47.1% (6962/14782) of return visits at Site one, compared to 24.8% (2968/11973) and 13.5% (7815/57684) at Site two. Although video visits were the predominant modality at both institutions in 2023, phone visits accounted for 4.4% (409/9260) of telemedicine visits at Site One, compared to 22.5% (2429/10783) at Site Two.
Conclusion: In this multi-institutional study of telemedicine trends, we observed an initial surge in telemedicine adoption in radiation oncology clinics in 2020, followed by sustained utilization from 2021 to 2023. While differences in overall proportion, visit type distribution, and telemedicine modality were observed, this study demonstrates the importance of continued integration of telemedicine into radiation oncology care at these major institutions, each with different geographical distributions across the United States.