Patient Perceptions Around Quality of Care Through Telemedicine in Neuro-Oncology

Recruiting

Conditions: Central Nervous System Neoplasm
Primary Brain Neoplasm
Leptomeningeal Neoplasm
Metastatic Malignant Neoplasm in the Brain

Interventions: Other: Electronic Health Record Review
Other: Survey Administration

Brief Summary: This study evaluates patient perceptions around quality of care through telemedicine in neuro-oncology. Studying questionnaires related to perceptions quality of care through telemedicine in patients with brain cancer may help doctors to improve the delivery of care through this modality.

Detailed Description: PRIMARY OBJECTIVE:

I. To evaluate the patient-perceived quality of care by group (telemedicine versus in-person visits) in patients with central nervous system (CNS) cancer.

SECONDARY OBJECTIVES:

I. To characterize the visits provided by telemedicine compared to those in-person.

II. To contrast the average time spent on telemedicine visits compared to in-person visits, and the delay between visit order placement and visit occurring.

III. To evaluate the domains of patient care addressed on a telemedicine visit versus in-person visit per documentation, including (1) treatment planning, (2) symptom burden, (3) goals of care.

IV. To evaluate frequency of acute care sought (through emergency room or urgent care clinic) within 30 days of encounter in telemedicine visit versus (vs) in-person visit.

V. The impact of patient and clinical characteristics on perceived quality of care in the context of covariate-adjusted modeling.

OUTLINE:

Patients complete a survey related to their perceived quality of care via telephone and have their medical chart reviewed prospectively.

Recruitment & Eligibility

Inclusion Criteria

Patients with a CNS tumors: this includes patients with primary brain tumors, brain metastases, and leptomeningeal disease
Established patients with a follow up encounter with Neuro-Oncology at the Brain and Spine Center at the University of Texas MD Anderson Cancer Center; this encounter can be
- An in-person visit
- A telemedicine appointment

Exclusion Criteria

Encounter occurred with the assistance of official language translation support
Patients with telephone encounters (without interactive video)
New patient or consult visits
Neither patient nor caregiver present during the visit are available or able to answer survey questions

Arm && Interventions

Group	Intervention	Description
Observational (survey, medical chart review)	Electronic Health Record Review	Patients complete a survey related to their perceived quality of care via telephone and have their medical chart reviewed prospectively.
Observational (survey, medical chart review)	Survey Administration	Patients complete a survey related to their perceived quality of care via telephone and have their medical chart reviewed prospectively.

Primary Outcome Measures

Name	Time	Method
Survey response to question 6 of the quality of care survey ("I felt I received good medical care during this encounter")	through study completion, an average of 1 year	Survey responses will be summarized by ordinal category as counts with percentages, separately by group. Will separately estimate the proportion of each ordinal level of each group with 95% confidence interval.

Secondary Outcome Measures

Name	Time	Method
Interactive time spent during visit	through study completion, an average of 1 year	Will be summarized by group per mean, median, standard deviation, and range. Differences between groups will be assessed by t-test and Mann-Whitney test.
Quality of Care Survey	through study completion, an average of 1 year	Will separately estimate the proportion of each ordinal level of each group with 95% confidence interval.
Patients and clinical characteristics	Baseline	Differences between groups will be assessed by 2-sample 2-sided t-test and Mann-Whitney test, Fisher's exact test, or chi-square test.
Time from visit order placement to visit occurring	through study completion, an average of 1 year	Will be summarized by group per mean, median, standard deviation, and range. Differences between groups will be assessed by t-test and Mann-Whitney test.
Domains of patient care addressed during a visit, including treatment planning, symptom burden, and goals of care	through study completion, an average of 1 year	Will be summarized as counts with percentages by group. Differences between groups will be assessed by chi-square test.
Incidence of acute care sought (through emergency room or urgent care clinic)	Within 30 days of encounter	Will be summarized as counts with percentages by group. Differences between groups will be provisionally assessed by Fisher's exact test.