Telemedicine Use and Satisfaction Amongst Radiation Oncologists During the COVID-19 Pandemic: Evaluation of Current Trends and Future Opportunities

PURPOSE/OBJECTIVE(S): During the COVID-19 pandemic telemedicine became an attractive alternative to in person appointments. The role of telemedicine in patients who undergo frequent on-site treatment, such as radiation therapy, is unclear. The purpose of this study was to examine telemedicine use, physician satisfaction and barriers to continued use in radiation oncology. MATERIALS/METHODS: An anonymous, electronic survey was distributed to radiation oncologists internationally. Participants described demographic and practice characteristics and a 5-point Likert scale assessed provider satisfaction, ease of use and overall utility of telemedicine. Analyses include descriptive statistics and subgroup comparisons using Chi-square and Fisher's exact test. RESULTS: 232/5343 (4.3%) completed the survey, 63.8% of whom were male, 52.6% age 50 or younger and 78.0% from the United States (U.S.). Only 14.2% used Telemedicine previously, which increased to 93.1% during COVID-19. Amongst all telemedicine users, usage rates were 77.9% for initial consultations, 97.2% for follow-up visits, and 35.9% for on-treatment visits. 69.8% report that < 25% of patients requiring treatment experienced delays due to COVID-19. Most conducted appointments from the workplace, with 40.1% also doing so from home. Satisfaction was high at 73.8%, perceived usefulness was 76.9% and 81.5% hope to continue using telemedicine after the pandemic. However, 82.4% had concerns with the inability to examine patients. Although 82.1 % believed that telemedicine would improve patient access to health care services overall, 63.0% were concerned with patient ability to access required technology. 49.5% had concerns regarding continued billing/reimbursement; less commonly at government centers (18.8%) compared to academic/satellite facilities (52.7%) and free-standing centers/community hospitals (50.7%), P = 0.039 for both comparisons. These concerns were also significantly higher amongst US physicians (53.2% vs 34.9%, P = 0.048). CONCLUSION: Widespread adoption of telemedicine by radiation oncologists occurred during COVID-19 with high rates of satisfaction and interest in continued use. Sustained reimbursement for telemedicine services is a significant concern, particularly in the US and outside of government facilities.