Cancer Clinician Experiences With Telehealth Across Oncology Specialties: Cross-Sectional Survey Study.

Abstract

Background: Telehealth use expanded rapidly during the COVID-19 pandemic and has since become integrated into routine oncology care. However, clinician experiences and confidence with telehealth may vary across oncology subspecialties, and these differences remain incompletely characterized.

Objective: This study aimed to evaluate telehealth perceptions, decision-making factors, and confidence across oncology clinicians from multiple specialties at a single academic cancer center.

Methods: We conducted a cross-sectional survey of oncology clinicians at the University of California San Diego Moores Cancer Center. A 27-item Qualtrics questionnaire was distributed by email to attending physicians, fellows, and advanced practice providers across surgical, medical, radiation, and palliative oncology. Survey domains included telehealth coordination, technical quality, communication effectiveness, confidence in remote physical examination, and factors influencing visit modality selection. Quantitative responses were summarized descriptively, and open-ended responses underwent thematic analysis.

Results: Among 114 invited clinicians, 57 (50%) complete responses were analyzed. Among 57 respondents, 86% (n=49) were physicians. Specialties included surgical oncology (n=21, 36.8%), medical oncology (n=18, 31.6%), radiation oncology (n=16, 28.1%), and palliative care (n=2, 3.5%). Telehealth coordination was rated easy or very easy by 78.9% (n=45) of clinicians. Audio and video quality were rated good or very good by 71.9% (n=41) and 57.9% (n=33), respectively. Technical issues prompted at least occasional conversion to audio-only visits for 86% (n=49) of respondents, and 17.5% (n=10) of clinicians reported frequent conversion. Communication satisfaction was high (n=48, 84.2%), yet only 50.9% (n=29) reported moderate or high confidence in performing a virtual physical examination. The need for physical examination (n=53, 93%) and patient travel distance (n=45, 78.9%) were the most influential factors in offering telehealth visits. Confidence varied by specialty and clinical phase: moderate or high confidence was reported by surgical oncology clinicians in 52.4% (11/21) of preoperative and 71.4% (15/21) of postoperative responses, by medical oncology clinicians in 77.8% (14/18) of prechemotherapy and 76.5% (13/17) of during chemotherapy responses, and by radiation oncology clinicians in 87.5% (14/16) of preradiation and 93.8% (15/16) of during radiation responses.

Conclusions: Oncology clinicians reported generally positive experiences with telehealth, although confidence and use patterns varied across specialties and phases of care. Telehealth is viewed as a complementary modality when physical examination is not essential. Improvements in technical reliability and interpreter integration may enhance equitable access and support continued telehealth use in oncology care.