Telemedicine Eliminated Travel, Cost Burdens for Patients Seeking Urologic Cancer Care in WWAMI Region

Telemedicine effectively eliminated significant travel burdens for patients with urologic cancers who were seeking quality cancer care, according to a presentation at the 21st Annual Meeting of the Society of Urologic Oncology (SUO).

“We all know what happened in February and March of 2020 with the COVID pandemic, and as we and many others converted our clinics to predominant or exclusive telemedicine, we saw a large uptick in the use of telemedicine,” Adam J. Gadzinski, MD, MS, urologic oncology fellow at the University of Washington, said in his presentation. “Likewise, for our study, [we saw] a large uptick of patients completing the post-visit survey who had telemedicine visits for a urologic-oncologic problem.”

Of the 1453 eligible patients, 615 (42%) completed a post-visit survey from August 2019 to July 2020, starting with the introduction of telemedicine at the University of Washington, which serves as one of the main referral centers for the WWAMI region. Of those 615 patients, 198 visited in-person for an appointment and 417 had telemedicine appointments.

For the patients who visited in-person, the median one-way travel time was 197 minutes compared to 15 miles for patients visiting via telemedicine. Median one-way travel distance was 123 miles for in-person visitors, with a median total travel cost of $100, compared to 0 miles and dollars for those visiting via telemedicine.

Median age for the patients was 68 years, with 89% of the cohort comprised of males and 73% categorized as white. The patients visited for prostate cancer (62%), urothelial cancer (22%), kidney cancer (14%), and testis cancer (2%).

No significant differences were noted in patient satisfaction between both in-person and telemedicine visits.

“We have a not insignificant portion of our patients who have to fly and also who have to stay in a hotel for these visits. A humbling statistic here is that 11% of patients paid over $1000 in their travel expenses for an outpatient urologic oncology visit,” said Gadzinski. “Telemedicine virtually eliminated those costs.”

Gadzinski explained that their interest in telemedicine stemmed from the ability to utilize telemedicine as a way to address disparities in access to quality urologic cancer care. He explained that 60% of the counties in the United States do not have access to a single practicing urologist, equating to about 47 million Americans who live in a county without a practicing oncologist.

The team of researchers utilized a prospective cohort study and analyzed patient-reported outcomes via a post-visit survey to ultimately compare the reported outcomes between patients evaluated for urologic cancer care via telemedicine and patients evaluated in-person.

Looking ahead, the researchers don’t yet know whether telemedicine can have an impact on both an individual’s cancer outcome and the health of rural or underserved populations from a cancer care perspective.

“Finding ways to use telemedicine and other means to increase our access to urologists for these patient populations was incredibly important,” said Gadzinski.

Reference:

Gadzinski AJ, Abarro IO, Stewart B, et al. The impact of telemedicine on patient-reported outcomes in urologic oncology. Presented at: 21st Annual Meeting of the Society of Urologic Oncology; December 3, 2020. Abstract #14.