Background: The COVID-19 pandemic has led to the rapid expansion of telehealth use. Telehealth has the potential to improve access for underserved populations who live far distances from well-equipped medical centers. This healthcare modality will likely be particularly important for patients with cancer. We hypothesized that there are disparities in the resources available to utilize telehealth and sought to study patient access and knowledge of associated technologies. Methods: We conducted a single-center cross-sectional survey study of patients at an NCCN-designated comprehensive cancer center over a two-month period. Demographics, education, internet, and cell phone access were assessed. Participant technological knowledge was determined with a validated 10-question quiz of terms regarding computers and the internet. Income was extrapolated using IRS data for individual zip codes. Analysis was performed using either an ordered logistic regression or mixed model ordered logistic regression (Stata SE 16.1). Results: There were 344 survey responses (rate 64.3%). Mean age of the respondents was 57.5 years, 70.0% were women, 67.3% were Caucasian, and 25.4% were Black. Many patients (35.0%) did not attend college, and 5.0% had not finished high school. The median estimated income was $45,820. Ninety-six patients (30.0%) did not have adequate internet access for telehealth use with 6.5% not having any internet access at all. Participants scored an average of 57.4% correct on the technology knowledge quiz. In unadjusted analysis, technological knowledge was predicted by age (Fig A), race (Fig B), income (Fig C), education level (Fig D), and cell phone type (Fig E). The type of home internet access and was not predictive of quiz score. Age, race, education level, and cell phone type remained significantly predictive of technological knowledge in multivariable analysis (Fig F). Home internet access (p = 0.416) and median income (p = 0.109) were not significantly associated with quiz score. Conclusions: In our sample, nearly one-third of cancer patients did not have adequate internet access for telehealth. There were significant disparities in technological knowledge among cancer patients which were associated with demographic characteristics. This study provides information for identifying patients that may have barriers to successful utilization of telehealth.
Technology Knowledge Quiz Score
Citation: Journal of the National Comprehensive Cancer Network 19, 3.5; 10.6004/jnccn.2020.7771
