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- Title
Patient Safety and Satisfaction With Fully Remote Management of Radiation Oncology Care.
- Authors
Cuaron, John J.; McBride, Sean; Chino, Fumiko; Parikh, Dhwani; Kollmeier, Marisa; Pastrana, Gerri; Wagner, Keri; Tamas, Andrew; Gomez, Daniel
- Abstract
Key Points: Question: How do patients receiving radiation oncology care with fully remote physician management rate their satisfaction with this option, and what are the associated safety events, financial implications, and environmental consequences? Findings: In this cohort study of 2817 patients, more than 99% of safety events did not reach patients or caused no harm to patients and 98% of patient ratings of satisfaction with fully remote management were good to very good. Out-of-pocket cost savings associated with fully remote management totaled approximately $612 913 ($466 per patient), and estimated carbon dioxide emissions decreased by 174 metric tons. Meaning: These findings suggest that a fully remote management option for properly selected patients receiving radiotherapy is safe and may preserve patient and clinician flexibility, expand access, create less financial toxicity, and reduce the carbon footprint. This cohort study evaluates patient safety and satisfaction, financial implications, and environmental consequences associated with fully remote physician management of radiation oncology care. Importance: Patients of Memorial Sloan Kettering Cancer Center in New York, New York, are now offered a choice of either in-person or remote telehealth visits for radiation oncology care. However, safety and satisfaction among patients receiving treatment with fully remote physician management is unclear. Objective: To analyze patient safety and satisfaction, financial implications, and environmental consequences associated with fully remote management among a cohort of patients treated with radiotherapy. Design, Setting, and Participants: This single-institution retrospective cohort study was performed at Memorial Sloan Kettering Cancer Center, with patients treated with radiation who opted for fully remote management between October 1, 2020, and October 31, 2022. Data on patient safety events were prospectively collected with an in-house quality improvement reporting system. Patient satisfaction surveys were distributed electronically before, during, and after treatment. Patient transportation costs and environmental consequences were estimated based on differences in travel distance. Data analysis was performed from March 14 through September 19, 2023. Exposure: Radiotherapy with fully remote physician management. Main Outcomes and Measures: Satisfaction rates among patients opting for fully remote management were analyzed via surveys administered electronically after visits with clinicians. Patient safety events, defined as staff-reported actual events and near misses that had the potential to affect patient care, were reviewed. Rates and types of safety events were analyzed and compared with patients treated by onsite clinicians. Distances between patient home zip codes and treatment site locations were compared with estimated cost savings and decreased emissions. Results: This study included 2817 patients who received radiation oncology care with fully remote physician management. The median age of patients was 65 (range, 9-99) years, and more than half were men (1467 [52.1%]). Of the 764 safety events reported, 763 (99.9%) did not reach patients or caused no harm to patients. Nearly all survey respondents (451 [97.6%]) rated patient satisfaction as good to very good across all domains. For treatment with fully remote physician management, out-of-pocket cost savings totaled $612 912.71 ($466.45 per patient) and decreased carbon dioxide emissions by 174 metric tons. Conclusions and Relevance: In this study, radiation oncology care provided by fully remote clinicians was safe and feasible, with no serious patient events. High patient satisfaction, substantial cost savings, and decreased environmental consequences were observed. These findings support the continuation of a fully remote management option for select patients in the post–COVID-19 era.
- Subjects
NEW York (State); CANCER treatment; SELF-evaluation; RADIOTHERAPY; PATIENT safety; ECOLOGY; RESEARCH funding; CANCER patient medical care; TRAVEL; ONCOLOGY; RETROSPECTIVE studies; CHI-squared test; DESCRIPTIVE statistics; TELEMEDICINE; LONGITUDINAL method; EXPERIENCE; MEDICAL records; ACQUISITION of data; PATIENT satisfaction; TUMORS; DATA analysis software; MEDICAL care costs; SPECIALTY hospitals; PATIENTS' attitudes
- Publication
JAMA Network Open, 2024, Vol 7, Issue 6, pe2416570
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.16570