Telehealth In Outpatient Pediatric Neuro-Oncology Care

Abstract BACKGROUND Telehealth is an emerging modality that can include patient evaluation, review of test results, and clinical decision-making. Access to care and quality of life are challenges for patients with pediatric brain tumors and their families. Herein we describe the introduction of video visits within our outpatient services led by nurse practitioners and nurse coordinators. METHODS The pediatric neuro-oncology program at University of California, San Francisco - Benioff Children’s Hospital (UCSF) established a robust telehealth practice to improve access to care for children and young adults with brain and spine tumors. Our nursing team identifies appropriate time points to offer video visits in lieu of in-person visits. Families are guided to connect through secure video conferencing. Data was collected retrospectively through electronic medical record schedules, billing records, and UCSF patient satisfaction surveys. RESULTS Since 2015 we have utilized telehealth for over 400 encounters. The service was limited to patients located in California. Introduction of telehealth resulted in savings of 2300 hours of travel by car, over $22,000 in gas, and over 127,000 miles traveled. Surveys indicate patient satisfaction is equal to or better than in-person experiences. Anecdotally, this service allows for face-to-face contact with patients who have significant barriers to travel. Challenges have included technology platforms, native language, provider and patient acceptance, and billing. CONCLUSION Overall, telehealth is feasible as a tool to deliver outpatient care in pediatric neuro-oncology. Implementation of video visits in clinical practice increases access to neuro-oncologic care and improves quality of life for patients and families.