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Telehealth and Time-to-Treatment Initiation Among Breast Cancer Patients During COVID-19: A Retrospective Cohort
Nancy Heffernan1, MaryPat Porinchak1, Shiela M Strauss1,2
1Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Background:
COVID-19 caused disruptions in access to oncology health care for patients with breast cancer. This study explored the time differences in days from the initial patient call to time-to-treatment initiation (TTI) and evaluated the relationship between initial in-person consult (IPC) and telehealth consult (THC).
Methods:
Retrospective data were collected for the years 2019, 2020, and 2021. Demographic characteristics were summarized for each year. Chi-square and nonparametric tests were used to examine demographic data, differences in the number of THCs versus IPCs each year, differences in TTI for patients who had THC versus IPC for each study year, and overall differences across each of the study years in TTI.
Results:
Records from 960 patients included 447 IPCs in 2019; 81 THCs and 47 IPCs in 2020; and 26 THCs and 359 IPCs in 2021. Significant differences were found for age (p = 0.013) between 2019, 2020, and 2021 (medians of 55, 51, and 55, respectively). Differences between the number of IPCs versus THCs from 2019 to 2021 combined were statistically significant (p < 0.001): 2019 (no THCs), 2020 (63% THCs vs. 37% IPCs), and 2021 (93% IPCs vs. 7% THCs). In 2019-2021, TTI was greater for patients who had an IPC versus those who had a THC; the median TTI was 28 days for THC versus 33 days for IPC, p = 0.045.
Conclusions:
Findings suggest that THCs did not delay and may accelerate TTI. Further studies examining the relationship of initial consult type to TTI are needed.
