Priority setting of teleoncology services, and their barriers, and facilitators from oncologists and patients perspectives: a mixed-methods study
摘要
Cancer is the second leading cause of death worldwide. Unlike the potential of telemedicine in the follow-up of chronic patients, many patients are still being examined in-person traditionally. This study aimed to prioritize teleoncology services and identify implementation barriers, and facilitators from oncologists’ and patients’ perspectives.
MethodThe research employed a mixed-methods approach, combining open-ended questions and interviews with both patients and oncologists. A total of 63 patients and 13 oncologists participated in the study. The data analysis utilized chi-square tests and descriptive statistics. Additionally, a qualitative content analysis was performed using MAXQDA 20 to analyze the data obtained from the open-ended questions and interviews.
ResultAccording to oncologists, the prioritization of teleoncology was described as follows based on several factors such as screening protocols, prevalence rates and complexity of diagnosis: (1) breast/gastrointestinal, (2) respiratory/cervical/prostate/skin, (3) neurology/head and neck, (4) gynecological and genitourinary, (5) endocrine and neuroendocrine, musculoskeletal system, and (6) eye. Ten out of 13 (77%) oncologists identified remote consultation between physicians as their highest priority, while 11 of them (85%) considered follow-up as the second most important. Moreover, 12 oncologists (92%) ranked remote diagnosis as their third priority. The majority of patients (66.7%) expressed a preference for in-person visits. Three key factors influencing the choice of in-person visits for patients were: feeling inadequate care during telemedicine visits, lack of digital knowledge, and being in the active treatment period. For patients, education level and preference of treatment method (in-person versus telemedicine) showed statistically significant association (Value < 0.05).
ConclusionTelemedicine was most favorable for teleconsultation between treating physicians and consultants. Lack of insurance cover, limited internet coverage, lack of local guidance, and insufficient continuous education were expressed as the main challenges for teleoncology. Addressing these challenges and prioritizing the needs of specialists are key factors in the promotion of telemedicine.