From Face-to-Face to Digital Spaces: A Critical Look at Patient Satisfaction with Telehealth in Cancer Care

Abstract

Purpose/Objective(s)

Telehealth encounters offer a convenient alternative to traditional healthcare access, mitigating infection risk and providing a critical safeguard for immunocompromised patients, such as those undergoing oncology treatment. Despite its growing usage, there is a lack of research on telemedicine’s impact on the quality of healthcare delivery. In this study, we provide a comprehensive analysis of our institutional data, highlighting the impact of telehealth on patient satisfaction relative to a carefully matched cohort of in-person encounters.

Materials/Methods

A 14-item CMS approved Patient Satisfaction (PS) survey was administered to patients at four outpatient academic radiation oncology centers from May 2021 to November 2023. Four survey questions were analyzed: team member listened, team member explained, enough input in care, and the likelihood of facility/provider recommendation. The likelihood of recommending the facility and/or provider was gauged on a 0-10 scale, with 9-10 indicating a higher likelihood of endorsement. Responses to the other questions were measured on a 0-4 Likert scale, where 4 signifies “Yes, definitely”, indicating satisfaction for the given question. A previous analysis has identified five key factors that independently influence PS: Area Deprivation Index (ADI), gender, cancer diagnosis, treatment intent, and survey visit type. Based on these findings, a matched pair analysis was conducted, ensuring participants were paired based on these criteria to accurately assess the impact of telehealth on PS. Univariate (UVA) and multivariable (MVA) logistic regression analyses determined the impact of these factors on recommendation scores.

Results

Out of 7,501 collected surveys, 528 (7%) were collected from telehealth encounters. After matching, patients in the telehealth group reported less satisfaction across all questions, including team member listened (P < 0.001), team member explained (P < 0.001), enough input in care (P < 0.001), facility recommendation (P = 0.003), and provider recommendation (P = 0.012) compared to in-person visits. MVA highlighted that patients who were satisfied with “enough input in care” (OR = 86.9, P = 0.002) and “team member explained” (OR = 9.3, P < 0.001) were more likely to recommend the facility and the provider.

Conclusion

In this study, we found that patients are overall less likely to report high satisfaction with their telehealth compared to in-person encounters. The factors driving whether patients are likely to recommend the facility or the provider were higher satisfaction with the input they had in their care and whether the provider explained well. Further research is needed to address potential limitations of telemedicine encounters to increase access to health, particularly for patients at risk of severe infections, without compromising overall quality of care.