HSR22-135: Telemedicine for Cranial Radiosurgery Patients in a Rural US Population: Patterns and Predictors of Patient Utilization

Authors: Daniel T Cifarelli MD, MS1 and Christopher P Cifarelli MD, PhD, MMM1
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  • 1 West Virginia University, Morgantown, WV

INTRODUCTION: Telemedicine retains potential for increasing access to specialty providers in underserved and rural communities. COVID-19 accelerated adoption of tele-healthcare beyond rural populations, serving as a primary modality of patient-provider encounters for many non-emergent diagnoses. Methods: From 2020-2021, telemedicine was incorporated in management of stereotactic radiosurgery patients. Retrospective data on diagnoses, demographics, distance to primary clinic, and encounter type were captured and statistically analyzed using descriptive measures and Cox proportional regression modeling. Graphical representation of service areas were created using geo-mapping software. Results: 208 patients completed 331 telemedicine encounters over 12 months. Metastases and meningiomas comprised 60% of diagnoses. Median age was 62 years with median household income and residential population of $44,752 USD and 7634 people. The one-way mean and median travel distances were 74.6 and 66.3 miles. The total potential road mileage for all patients was 44,596 miles. 118 (57%) patients completed video visits during the first encounter while 90 (43%) opted for telephone encounters. At 12 months, 138 patients (66%) utilized video-visits and 70 (34%) used telephone-visits. Predictors of video-visit use were video-enabled visit during the first encounter (HR 2.806, p<0.001), total potential distance traveled (HR 1.681, p<0.05), and the need for more than one visit per year (HR 2.903, p<0.001). Discussion: Telemedicine can be effective in radiosurgery practice with predictors of video-enabled use being pre-existing patient comfort levels with video-conferencing, total annual travel distance, and number of visits per year. Age, rural population status, and household income did not impact telemedicine use in our patient cohort.

Corresponding Author: Daniel T. Cifarelli, MD, MS
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