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Remote radiation oncology consultations more likely in the future

Greater remote radiation oncology consultations are likely in the future after a study found a reduced need for face-to-face appointments.

Due to the COVID-19 pandemic there has been a major overhaul in the delivery of healthcare provision across all specialities, with a greater shift towards remote and tele-health consultations. In fact, the Australian government made the decision that tele-health would become a weapon against COVID-19 and expanded consultation services available through this medium. According to the results of a study by researchers from Canberra Hospital, Australian, telephone and/or tele-health consultations are likely to play a more prominent role in radiation oncology services. Although before the current pandemic, there was some evidence for the value of follow-up telephone consultations for breast cancer patients and those with stage-I endometrial cancer, COVID-19 enabled the acceleration of remote consultations.

For their study, the Australian team wanted to know the percentage of telephone/tele-health radiation oncology consultations that subsequently resulted in the need for a face-to-face appointment during the first wave of the 2020 COVID-19 pandemic. Moreover, where a face-to-face consultation was needed, the team examined the reasons why this form of consultation was required. Using a retrospective design, a de-identified dataset report was created from the department’s oncological information system (ARIA) spanning a 10-week period from 23 March to 28 May 2020. The researchers extracted patient demographic data including the area of residence and diagnoses based on ICD-10 codes and additional data from the clinic appointments such as the appointment type, e.g., initial or follow-up. The patient’s medical records were then reviewed to categorise the reasons for the subsequent face-to-face consultation and these were recorded as frequency counts.

Findings

During the study period, a total of 1159 radiation oncology consultations were undertaken with 973 patients. Overall, 696 (60%) of all consultations were conducted via the telephone, of which, 649 were for a follow-up appointment and the remaining 47, an initial appointment. However, less than 1 per cent of all (4/696) were conducted using tele-health. Of those who had a telephone/tele-health consultation, only 66 (9% of all telephone/tele-health consultations) subsequently required a face-to-face consultation. Among these 66 patients, the most common reason (45%) was the need for written consent prior to radiotherapy. Other reasons included the need for a clinical examination of a new problem (24%) and for a new investigation (7.5%). For the 16 (24%) patients needing a clinical examination for a new problem, the primary sites of disease were breast (4), mucosal head and neck (3), skin (3), endometrium (2), oral cavity (1), rectal (1), lung (1), and prostate (1).

The authors concluded that “A large proportion of radiation oncology appointments can be completed using telephone/tele-health, with a relatively small number of these requiring subsequent face-to-face appointments.” Nevertheless, they cautioned that “careful patient selection and accounting for multiple variables would be needed to ensure effective and safe healthcare is provided.”

Source. It’s a sign of the times:Our experience with telephone/tele-health consultations for radiation oncology patients in Canberra during the COVID-19 pandemic. The Royal Australian and New Zealand College of Radiologists conference 2021.



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