Remote care management boosts patients’ satisfaction while saving them $613,000 over 2 years

Remote management of radiation oncology care can boost patients’ satisfaction while saving them hundreds of thousands in out-of-pocket costs, according to new research.

Memorial Sloan Kettering Cancer Center in New York recently established such a telehealth program to expand access, meet demand for care closer to home and preserve continuity. The model allows physicians to handle the initial consultation, therapy planning and on-treatment management via the organization’s expanded telehealth infrastructure.

Radiation oncologist John J. Cuaron, MD, and colleagues analyzed data from the first two years of the program ending in October 2022, detailing their work in JAMA Network Open [1]. They found clear signs of success, with nearly 98% of patients rating their experience as good to very good. The service also saved patients $613,000 (or $466 per individual) in out-of-pocket costs while decreasing carbon dioxide emissions by 174 metric tons due to fewer required car trips.

“Radiation oncology care provided by fully remote clinicians was safe and feasible, with no serious patient events,” Cuaron and co-authors wrote June 12. “High patient satisfaction, substantial cost savings and decreased environmental consequences were observed. These findings support the continuation of a fully remote management option for select patients in the post–COVID-19 era.”

The study included a total of over 2,800 patients who received radiation oncology care via fully remote physician management. There were 764 safety events reported during the study period. However, all but one (or 99.9%) did not reach patients or caused zero harm. One individual experienced a seizure while undergoing treatment, requiring activation of emergency services. This this was labeled as a “grade 2” event (resulting in temporary or minor harm) and was not attributed to remote management. Zero grade 3 or 4 events occurred during the study period. Other mistakes included treatment planning issues (42%), planning or delivery delays (12%), scheduling errors (11%) and physician order entry issues (9%).

Cuaron and co-authors also administered patient satisfaction surveys before, during and after treatment. Only about 31% of patients (or 873 individuals) responded to the questionnaire. Most respondents (88%) either preferred telehealth or expressed no preference for in-person versus fully remote visits. The remainder (12%) stated a preference for in-person visits.

Out of the 2,817 patients who received fully remote care, about 47% were treated via Memorial Sloan Kettering’s regional network. Delivering care at these network sites in New York or Jersey versus the main Manhattan campus saved a total of 434,530 miles of driving distance, or an average of 331 per patient during RT, the authors estimated. Regional campus treatment was tied to total savings of $612,912.71, which accounts for fuel and parking costs.

“The findings of this study support a continued favorable view of elective virtual treatment visits, with no apparent shift in preference toward either telehealth or in-person visits over time,” the authors reported. “An important distinction of fully remote management is that telehealth visits comprise only a component of care. The additional features of expanded access through clinician and treatment location flexibility, a robust patient triage system, and reduced out-of-pocket patient costs are notable benefits of the remote management model and distinguish this study from the expanding teleoncology literature.”

Read more at the link below, including potential limitations. Cuaron and colleagues said MSK plans to continue the program, allowing for the “preservation of patient and clinician flexibility, expanded access, and decreased financial toxicity among properly selected patients.”

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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