Patient safety, satisfaction soar with remote care management

Telehealth continues to prove a useful tool for remote care management, with new JAMA Network Open data showing it can yield high patient satisfaction without any adverse patient safety events.

The study, completed by researchers from Memorial Sloan Kettering Cancer Center, showed that patients receiving radiation oncology care with fully remote physician management thought the care delivered via telehealth was good or very good. Meanwhile, nearly every patient included in the study dodged any potential adverse safety events.

COVID-19 brought in an insurgence of telehealth-enabled care management, including in cancer care. During the pandemic, patients reported excellent satisfaction and healthcare researchers found that clinical quality remained stable even during the transition to telehealth care management.

Once the initial surge of the pandemic subsided, many organizations reintroduced in-person care management.

But certain disease states and treatment options, like radiation oncology, have very high travel burdens. Radiation is administered to cancer patients every day, and if the treatment center is not close to home, it could be burdensome. There could be an opportunity to use remote care management in these cases.

Memorial Sloan Kettering designed a remote radiation oncology care model in which a patient could receive radiation at a quaternary referral academic cancer center closer to home. Initial consults, radiation treatment planning and on-treatment management can all be delivered via telehealth in this model.

This treatment model was ultimately successful in promoting patient satisfaction while keeping the risk for adverse patient safety events down, the study showed.

In a retrospective cohort study of nearly 3,000 patients at Memorial Sloan Kettering who opted for remote radiation oncology care between October 2020 and 2022, patient satisfaction scores were outstanding. Nearly every patient (98%) rated their satisfaction as good or very good across all domains.

Meanwhile, patient safety was a negligible issue. Over the study period, there were 764 patient safety events reported. That rate is higher than anticipated, the researchers acknowledged. However, all but one never reached the patient, meaning the adverse events never caused any patient harm.

"The fact that the rate of events per patient among patients receiving remote management was statistically higher than in previous years likely represents increased vigilance during initiation of the remote management program, which we anticipate will decrease as remote management workflows are improved," the researchers said.

There were other key benefits of the remote radiation care management program, the team reported. For example, patients saw significant travel distance reductions, with the program saving a total of 434,530 miles of driving distance. That's around 330.7 miles per patient during radiation treatment.

The program was also linked to around $612,900 in cost savings when accounting for fuel and parking costs. That's around $466.45 per patient.

"An important distinction of fully remote management is that telehealth visits comprise only a component of care," the researchers explained. "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."

These findings are relevant as healthcare considers the role of telehealth during COVID-19's endemic phases. The researchers said telehealth can be advantageous in terms of chronic care management.

"Offering patients initial visits in one location and treatment and weekly visits in another, all managed by the same physician, allows for increased access to clinicians who may have availability to see patients sooner," the researchers concluded.

Sara Heath has covered news related to patient engagement and health equity since 2015.