Physician perspectives on clinician-to-clinician telemedical consultation for gynecologic cancers: A qualitative study
Objective: Approximately fifteen million women in the United States live > 50 miles from a gynecologic oncologist. Telemedical technology allows patients’ local physicians to consult with subspecialist gynecologic oncologists without burdening patients with unnecessary in-person visits. Although...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Gynecologic Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578924000420 |
| _version_ | 1797234318547877888 |
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| author | Cheyenne Wagi David I. Shalowitz Aliza Randazzo Alexandra Peluso Sarah Birken |
| author_facet | Cheyenne Wagi David I. Shalowitz Aliza Randazzo Alexandra Peluso Sarah Birken |
| author_sort | Cheyenne Wagi |
| collection | DOAJ |
| description | Objective: Approximately fifteen million women in the United States live > 50 miles from a gynecologic oncologist. Telemedical technology allows patients’ local physicians to consult with subspecialist gynecologic oncologists without burdening patients with unnecessary in-person visits. Although critical to adoption of this technology, physicians’ input into implementation of clinician-to-clinician consultation has not been sought. We therefore gathered feedback about experiences with referrals, communication, and openness to telemedical consultation from gynecologic oncologists, gynecologists, and medical oncologists. Methods: We recruited gynecologic oncologists, gynecologists, and medical oncologists from practices serving rural patients to participate in semi-structured interviews. The Consolidated Framework for Implementation Research and the Theoretical Domains Framework guided the interviews. Questions focused on factors influencing adoption and implementation of clinician-to-clinician telemedicine. Interviews were conducted via WebEx, recorded, and transcribed. Two investigators coded interviews using the combined frameworks and identified salient themes. Results: We conducted 11 interviews (6 gynecologic oncologists, 3 gynecologists, 2 medical oncologists) and identified themes encompassing communication burnout, barriers to sharing patient information, need for further logistical information, and potential benefits to patients. Conclusions: Clinician-to-clinician telemedicine may improve access to gynecologic cancer care by decreasing barriers to subspecialty expertise while simultaneously benefiting referring and consultant clinicians through improved identification and workup of patients who may need in-person consultation. To optimize desired outcomes, telemedical consultation must allow for communication of relevant patient information and records and easy integration into clinical workflow. Importantly, clinicians must perceive the consultation as improving patients’ access to specialty care. |
| first_indexed | 2024-04-24T16:30:10Z |
| format | Article |
| id | doaj.art-21004da8346f4b52bdd18547fab6c6c8 |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-04-24T16:30:10Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-21004da8346f4b52bdd18547fab6c6c82024-03-30T04:39:29ZengElsevierGynecologic Oncology Reports2352-57892024-04-0152101363Physician perspectives on clinician-to-clinician telemedical consultation for gynecologic cancers: A qualitative studyCheyenne Wagi0David I. Shalowitz1Aliza Randazzo2Alexandra Peluso3Sarah Birken4Department of Implementation Science, Wake Forest University School of Medicine, United StatesWest Michigan Cancer Center, Kalamazoo, MI, United States; Collaborative on Equity in Rural Cancer Care, Kalamazoo, MI, United States; Corresponding author at: West Michigan Cancer Center, 200 N Park St, Kalamazoo, MI 49007, United States.Department of Implementation Science, Wake Forest University School of Medicine, United StatesDepartment of Implementation Science, Wake Forest University School of Medicine, United StatesDepartment of Implementation Science, Wake Forest University School of Medicine, United StatesObjective: Approximately fifteen million women in the United States live > 50 miles from a gynecologic oncologist. Telemedical technology allows patients’ local physicians to consult with subspecialist gynecologic oncologists without burdening patients with unnecessary in-person visits. Although critical to adoption of this technology, physicians’ input into implementation of clinician-to-clinician consultation has not been sought. We therefore gathered feedback about experiences with referrals, communication, and openness to telemedical consultation from gynecologic oncologists, gynecologists, and medical oncologists. Methods: We recruited gynecologic oncologists, gynecologists, and medical oncologists from practices serving rural patients to participate in semi-structured interviews. The Consolidated Framework for Implementation Research and the Theoretical Domains Framework guided the interviews. Questions focused on factors influencing adoption and implementation of clinician-to-clinician telemedicine. Interviews were conducted via WebEx, recorded, and transcribed. Two investigators coded interviews using the combined frameworks and identified salient themes. Results: We conducted 11 interviews (6 gynecologic oncologists, 3 gynecologists, 2 medical oncologists) and identified themes encompassing communication burnout, barriers to sharing patient information, need for further logistical information, and potential benefits to patients. Conclusions: Clinician-to-clinician telemedicine may improve access to gynecologic cancer care by decreasing barriers to subspecialty expertise while simultaneously benefiting referring and consultant clinicians through improved identification and workup of patients who may need in-person consultation. To optimize desired outcomes, telemedical consultation must allow for communication of relevant patient information and records and easy integration into clinical workflow. Importantly, clinicians must perceive the consultation as improving patients’ access to specialty care.http://www.sciencedirect.com/science/article/pii/S2352578924000420Gynecologic cancersCancer care delivery researchTelemedicineRural healthImplementation science |
| spellingShingle | Cheyenne Wagi David I. Shalowitz Aliza Randazzo Alexandra Peluso Sarah Birken Physician perspectives on clinician-to-clinician telemedical consultation for gynecologic cancers: A qualitative study Gynecologic Oncology Reports Gynecologic cancers Cancer care delivery research Telemedicine Rural health Implementation science |
| title | Physician perspectives on clinician-to-clinician telemedical consultation for gynecologic cancers: A qualitative study |
| title_full | Physician perspectives on clinician-to-clinician telemedical consultation for gynecologic cancers: A qualitative study |
| title_fullStr | Physician perspectives on clinician-to-clinician telemedical consultation for gynecologic cancers: A qualitative study |
| title_full_unstemmed | Physician perspectives on clinician-to-clinician telemedical consultation for gynecologic cancers: A qualitative study |
| title_short | Physician perspectives on clinician-to-clinician telemedical consultation for gynecologic cancers: A qualitative study |
| title_sort | physician perspectives on clinician to clinician telemedical consultation for gynecologic cancers a qualitative study |
| topic | Gynecologic cancers Cancer care delivery research Telemedicine Rural health Implementation science |
| url | http://www.sciencedirect.com/science/article/pii/S2352578924000420 |
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