L.A. Szczygiel1,2, J. Williams1,2, R. Jacobs3, K. Chan4,5, R. Bell3, M. Byrnes1,2, D. Odell1,2 1University Of Michigan, Department Of Surgery, Ann Arbor, MI, USA 2University Of Michigan, Center For Healthcare Outcomes And Policy, Ann Arbor, MI, USA 3Feinberg School Of Medicine – Northwestern University, Department Of Surgery, Chicago, IL, USA 4Loyola University Chicago Stritch School Of Medicine, Department Of Surgery, Maywood, IL, USA 5American College Of Surgeons, Cancer Scholar Program, Chicago, IL, USA
Introduction: Lung cancer remains a leading cause of cancer-related mortality worldwide, with regular surveillance playing a crucial role in monitoring disease progression and recurrence in survivors. Traditional surveillance methods often require frequent in-person visits, which can pose significant burdens on patients, particularly those facing geographical, financial, or health-related barriers to access. Telehealth has emerged as a potential solution to improve access to care and reduce patient burden across various medical specialties. However, its efficacy and acceptability in lung cancer surveillance remain understudied. The aim of this qualitative study is to explore patient experiences with telehealth in lung cancer surveillance, identifying key facilitators, barriers, and potential interventions for its successful implementation. By understanding these factors, we seek to inform the development of effective telehealth strategies that maintain high-quality care while improving accessibility and patient satisfaction in lung cancer surveillance.
Methods: We conducted 2 semi-structured interviews with patients with locally staged, early lung cancer patients in the post-surgery surveillance portion of their care, with plans to conduct approximately 20-30 interviews by the time of study conclusion. Participants were interviewed concerning their experiences of their lung cancer care, barriers and facilitators to attending surveillance visits, as well as attitudes toward telehealth as a modality for surveillance.
Results: We identified three themes which outline the ways that participants described telehealth for lung cancer surveillance: (1) Patient-centered and convenient, but with limitations; (2) Maintaining quality of care, but requiring adaptation; (3) Cost-effective, but necessitating a hybrid approach. Patients in this study appreciated the convenience of telehealth, with one patient noting it "worked out just fine" and "saved me a lot of money." Telehealth adoption was affected by patient comfort with technology, with some requiring assistance to "show me how to do everything." Participants described appropriate provision of care through telehealth, including sharing of vital signs and discussion of symptoms. However, sentiments around these virtual visits were influenced by the need for occasional in-person contact, with one patient expressing, "I like to get down there and actually see her face to face." Finally, participants described a need for a flexible system that combines telehealth with strategic in-person visits. This hybrid approach addressed concerns about comprehensive care, allowing for necessary procedures like scans and blood work to be done in person while routine follow-ups could be virtual.
Conclusion: Although participants in this study valued and were generally satisfied with telehealth for lung cancer surveillance, the need for occasional in-person visits was still present. Areas for deeper consideration are understanding barriers to technology adoption among patients, maintaining strong patient-provider relationships in a virtual setting, and developing effective hybrid care models that balance the benefits of telehealth with the necessity of in-person procedures and examinations.