JMIR Publications

ABSTRACT

Background:

Telehealth was an important method for maintaining continuity of cancer care during the coronavirus pandemic, however it is unknown whether services were equally available across cancer hospitals.

Objective:

To assess telehealth availability at cancer hospitals for new and established patients with common cancers.

Methods:

We conducted a national cross-sectional secret shopper study to assess telehealth availability at cancer hospitals from June-November 2020 for new and established patients with colorectal, breast, and skin (melanoma) cancer. We examined facility-level factors to determine predictors of telehealth availability.

Results:

Of the 312 investigated facilities, 96% provided telehealth services for at least one cancer site. Telehealth was less available to new compared to established patients (72% versus 96%). The surveyed cancer hospitals offered the most telehealth visits for breast cancer (85% of hospitals) while offering the least amount for melanoma patients (74%). A majority of hospitals offered telehealth for all three cancer types (52%). Telehealth availability was weakly correlated across cancer types within a given facility for new (r=0.16, 95% CI: 0.09-0.23) and established (r = 0.14, 95% CI: 0.08-0.21) patients. Telehealth was more commonly available for new patients at facilities that were NCI designated, medical school affiliated, major teaching sites, with high total admissions, and with below average timeliness of care. Telehealth availability for established patients was highest at Academic Comprehensive Cancer Programs, nongovernment, nonprofit facilities, medical school affiliated facilities, accountable care organizations, and facilities with high total admissions.

Conclusions:

Despite an increase in telehealth services for patients with cancer during the COVID-19 pandemic, we identified differences in access across cancer hospitals.