Sahil D Doshi, Yasin Khadem Charvadeh, Kenneth Seier, Erin M Bange, Bobby Daly, Allison Lipitz-Snyderman, Fernanda C G Polubriaginof, Michael Buckley, Gilad Kuperman, Peter D Stetson, Deb Schrag, Michael J Morris, Katherine S Panageas
{"title":"癌症患者对远程医疗就诊报告的看法。","authors":"Sahil D Doshi, Yasin Khadem Charvadeh, Kenneth Seier, Erin M Bange, Bobby Daly, Allison Lipitz-Snyderman, Fernanda C G Polubriaginof, Michael Buckley, Gilad Kuperman, Peter D Stetson, Deb Schrag, Michael J Morris, Katherine S Panageas","doi":"10.1001/jamanetworkopen.2024.45363","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>The COVID-19 pandemic catalyzed rapid adoption of telemedicine visits for cancer care delivery. However, patients' experiences with telemedicine remain poorly understood.</p><p><strong>Objective: </strong>To understand patients' satisfaction with telemedicine visits at a comprehensive cancer center.</p><p><strong>Design, setting, and participants: </strong>This survey study included patients with cancer at a US cancer center between 2020 and 2023. Eligible patients completed surveys in English conducted after their first telemedicine appointment via an online patient portal. Data were analyzed between January and June 2024.</p><p><strong>Exposures: </strong>Patient surveys about telemedicine experiences, with a specific comparison with an in-person visit. Structured items elicited satisfaction with the specific visit, preferences for future use of telemedicine, and technical ease of use; unstructured free-text responses were also elicited.</p><p><strong>Main outcomes and measures: </strong>Proportion of patients who indicated that telemedicine visits were superior or preferred to in-person visits. Secondary outcomes included multivariable analysis of barriers to telemedicine use and variations in patient experiences by demographic characteristics over the observation period, and free-text analysis of unstructured responses describing the telemedicine experience using the BERTopic algorithm and a language model.</p><p><strong>Results: </strong>A total of 27 435 telemedicine users completed surveys from May 2020 to October 2023 (median [IQR] age, 65 [55-72] years; 15 072 female [54.9%]; 1771 Asian [6.7%], 1339 Black [5.1%], 22 742 White [85.9%]). Overall, 18 025 of 24 418 patients (73.8%) rated their first telemedicine visit as good as or better than an in-person visit, and 4606 (18.9%) rated it superior to an in-person visit. The proportion of patients rating a telemedicine visit superior to an in-person visit evolved from 17% in 2020 to 20% in 2023. Structured questions revealed a positive view of telemedicine, while free-text analyses highlighted issues with technology.</p><p><strong>Conclusions and relevance: </strong>In this survey study of perspectives on telemedicine visits, a large majority of patients at a comprehensive cancer center expressed satisfaction with telemedicine visits in proportions that remained consistent beyond the end of the pandemic. These findings challenge health care systems to integrate telemedicine into routine cancer care and to overcome remaining technical challenges and barriers to ease of use.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2445363"},"PeriodicalIF":10.5000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568458/pdf/","citationCount":"0","resultStr":"{\"title\":\"Perspectives on Telemedicine Visits Reported by Patients With Cancer.\",\"authors\":\"Sahil D Doshi, Yasin Khadem Charvadeh, Kenneth Seier, Erin M Bange, Bobby Daly, Allison Lipitz-Snyderman, Fernanda C G Polubriaginof, Michael Buckley, Gilad Kuperman, Peter D Stetson, Deb Schrag, Michael J Morris, Katherine S Panageas\",\"doi\":\"10.1001/jamanetworkopen.2024.45363\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>The COVID-19 pandemic catalyzed rapid adoption of telemedicine visits for cancer care delivery. However, patients' experiences with telemedicine remain poorly understood.</p><p><strong>Objective: </strong>To understand patients' satisfaction with telemedicine visits at a comprehensive cancer center.</p><p><strong>Design, setting, and participants: </strong>This survey study included patients with cancer at a US cancer center between 2020 and 2023. Eligible patients completed surveys in English conducted after their first telemedicine appointment via an online patient portal. Data were analyzed between January and June 2024.</p><p><strong>Exposures: </strong>Patient surveys about telemedicine experiences, with a specific comparison with an in-person visit. Structured items elicited satisfaction with the specific visit, preferences for future use of telemedicine, and technical ease of use; unstructured free-text responses were also elicited.</p><p><strong>Main outcomes and measures: </strong>Proportion of patients who indicated that telemedicine visits were superior or preferred to in-person visits. Secondary outcomes included multivariable analysis of barriers to telemedicine use and variations in patient experiences by demographic characteristics over the observation period, and free-text analysis of unstructured responses describing the telemedicine experience using the BERTopic algorithm and a language model.</p><p><strong>Results: </strong>A total of 27 435 telemedicine users completed surveys from May 2020 to October 2023 (median [IQR] age, 65 [55-72] years; 15 072 female [54.9%]; 1771 Asian [6.7%], 1339 Black [5.1%], 22 742 White [85.9%]). Overall, 18 025 of 24 418 patients (73.8%) rated their first telemedicine visit as good as or better than an in-person visit, and 4606 (18.9%) rated it superior to an in-person visit. The proportion of patients rating a telemedicine visit superior to an in-person visit evolved from 17% in 2020 to 20% in 2023. Structured questions revealed a positive view of telemedicine, while free-text analyses highlighted issues with technology.</p><p><strong>Conclusions and relevance: </strong>In this survey study of perspectives on telemedicine visits, a large majority of patients at a comprehensive cancer center expressed satisfaction with telemedicine visits in proportions that remained consistent beyond the end of the pandemic. These findings challenge health care systems to integrate telemedicine into routine cancer care and to overcome remaining technical challenges and barriers to ease of use.</p>\",\"PeriodicalId\":14694,\"journal\":{\"name\":\"JAMA Network Open\",\"volume\":\"7 11\",\"pages\":\"e2445363\"},\"PeriodicalIF\":10.5000,\"publicationDate\":\"2024-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568458/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAMA Network Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1001/jamanetworkopen.2024.45363\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAMA Network Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jamanetworkopen.2024.45363","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Perspectives on Telemedicine Visits Reported by Patients With Cancer.
Importance: The COVID-19 pandemic catalyzed rapid adoption of telemedicine visits for cancer care delivery. However, patients' experiences with telemedicine remain poorly understood.
Objective: To understand patients' satisfaction with telemedicine visits at a comprehensive cancer center.
Design, setting, and participants: This survey study included patients with cancer at a US cancer center between 2020 and 2023. Eligible patients completed surveys in English conducted after their first telemedicine appointment via an online patient portal. Data were analyzed between January and June 2024.
Exposures: Patient surveys about telemedicine experiences, with a specific comparison with an in-person visit. Structured items elicited satisfaction with the specific visit, preferences for future use of telemedicine, and technical ease of use; unstructured free-text responses were also elicited.
Main outcomes and measures: Proportion of patients who indicated that telemedicine visits were superior or preferred to in-person visits. Secondary outcomes included multivariable analysis of barriers to telemedicine use and variations in patient experiences by demographic characteristics over the observation period, and free-text analysis of unstructured responses describing the telemedicine experience using the BERTopic algorithm and a language model.
Results: A total of 27 435 telemedicine users completed surveys from May 2020 to October 2023 (median [IQR] age, 65 [55-72] years; 15 072 female [54.9%]; 1771 Asian [6.7%], 1339 Black [5.1%], 22 742 White [85.9%]). Overall, 18 025 of 24 418 patients (73.8%) rated their first telemedicine visit as good as or better than an in-person visit, and 4606 (18.9%) rated it superior to an in-person visit. The proportion of patients rating a telemedicine visit superior to an in-person visit evolved from 17% in 2020 to 20% in 2023. Structured questions revealed a positive view of telemedicine, while free-text analyses highlighted issues with technology.
Conclusions and relevance: In this survey study of perspectives on telemedicine visits, a large majority of patients at a comprehensive cancer center expressed satisfaction with telemedicine visits in proportions that remained consistent beyond the end of the pandemic. These findings challenge health care systems to integrate telemedicine into routine cancer care and to overcome remaining technical challenges and barriers to ease of use.
期刊介绍：
JAMA Network Open, a member of the esteemed JAMA Network, stands as an international, peer-reviewed, open-access general medical journal.The publication is dedicated to disseminating research across various health disciplines and countries, encompassing clinical care, innovation in health care, health policy, and global health.
JAMA Network Open caters to clinicians, investigators, and policymakers, providing a platform for valuable insights and advancements in the medical field. As part of the JAMA Network, a consortium of peer-reviewed general medical and specialty publications, JAMA Network Open contributes to the collective knowledge and understanding within the medical community.
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