Telemedicine in Neuro-Oncology—An Evaluation of Remote Consultations during the COVID-19 Pandemic

SIMPLE SUMMARY: The COVID-19 pandemic has driven the expansion of remote consultations in medical care. However, their implementation in neuro-oncology comprises unique challenges and opportunities. Evidence for how the complex patient–doctor relationships and neurological examinations required in the treatment of brain tumor patients can be translated to video consultation is scarce. Therefore, we analyzed over 3700 consultations at our institution in order to determine how patients that decided to participate in remote consultations distinguished from patients that did not. Additionally, we queried them about their reasons, encounters, problems/limitations, opportunities, emotional impact and future directions regarding their experiences with telemedicine during their treatment with an anonymized survey. With this, we are able to provide guidance on suitable patient subgroups, occasions and future directives to expand and adapt telemedicine patient care in neuro-oncology in an individualized and evidence-based concept. ABSTRACT: In order to minimize the risk of infections during the COVID-19 pandemic, remote video consultations (VC) experienced an upswing in most medical fields. However, telemedicine in neuro-oncology comprises unique challenges and opportunities. So far, evidence-based insights to evaluate and potentially customize current concepts are scarce. To fill this gap, we analyzed >3700 neuro-oncological consultations, of which >300 were conducted as VC per patients’ preference, in order to detect how both patient collectives distinguished from one another. Additionally, we examined patients’ reasons, suitable/less suitable encounters, VC’s benefits and disadvantages and future opportunities with an anonymized survey. Patients that participated in VC had a worse clinical condition, higher grade of malignancy, were more often diagnosed with glioblastoma and had a longer travel distance (all p < 0.01). VC were considered a fully adequate alternative to face-to-face consultations for almost all encounters that patients chose to participate in (>70%) except initial consultations. Most participants preferred to alternate between both modalities rather than participate in one alone but preferred VC over telephone consultation. VC made patients feel safer, and participants expressed interest in implementing other telemedicine modalities (e.g., apps) into neuro-oncology. VC are a promising addition to patient care in neuro-oncology. However, patients and encounters should be selected individually.