Veterans Affairs hematology/oncology clinic video telehealth experience.

Abstract

281 Background: Many of the 40,000 veterans annually diagnosed with cancer have limited access to Hematology/Oncology care. An existing method to improve access in the Veterans Affairs (VA) system is the e-consultation, which allows text-based consultation by specialty services. However, many patients require more in-depth care than is feasible by e-consult. Amidst the COVID-19 pandemic, the James A. Haley VA (JAHVA) Hematology/Oncology department implemented VA video connect (VVC) telehealth visits to allow providers to connect with patients in their homes. Our aim was to assess the implementation of this novel telehealth service and assess provider perceptions via questionnaires. Methods: We reviewed charts of patients seen via VVC by the JAHVA Hematology/Oncology department. We gathered data including patient demographics, zip code, primary visit diagnosis, and date of visit. We adapted a previously validated telehealth usability questionnaire by Parmanto et al. Providers were surveyed about perceptions of VVCs prior to implementation and 1 year later. Responses were assessed via 5-point Likert scale. Results: From May 2020 to April 2021, 1290 VVCs were conducted. Median VVCs per month was 106 (range 26 to 161), with peak in June 2020. 71% of patients were ³65 years, 24% were 45-64 years, and 5% were <45 years. 77% of patients were white, 16% African American, 3% other, and 4% declined to answer or were of unknown race. 87% of patients were male. 12.5% of visits were for new consults. 41% of visits were for primary neoplasm-related diagnoses, 27% for hematologic diagnoses, and 32% for other. The mean residential distance from our clinic was 37.2 miles (range 0-212.7 miles). Sixteen Hematology/Oncology providers (faculty, fellows, advanced practice providers) completed the initial questionnaire, and 12 completed the follow-up questionnaire. See table for selected results. Conclusions: VVCs are a feasible method to provide remote access to care for patients. Utilization peaked in summer 2020, at the height of the COVID-19 pandemic. Providers were overall satisfied with video visits, though preference for in-person visits increased with time. Provider concern regarding personal and patient exposure to COVID-19 may have impacted perceptions regarding VVCs. Utilizing the PDSA cycle, future steps include identifying specific patient diagnoses and identifying reasons for VVC failure and using this data to optimize the experience for pati ent and providers.[Table: see text]