Increasing reach of cancer care: provider perspectives on the value and use of teleoncology

In-person cancer care within the national Veterans Health Administration (VA) system is challenging for many Veterans due to issues including rurality, transportation, finances, proximity to subspecialists, and other factors. The National TeleOncology Service (NTO) is a clinical service that enables VA oncologists from across the country to provide services via telehealth to Veterans with cancer. We sought to understand NTO providers’ perspectives on the role of the NTO in providing cancer care to Veterans via telehealth. We recruited NTO providers through their monthly office hours meeting for two focus groups held via Microsoft Teams in November 2023. We entered data from notes, transcripts, chats, and audio recordings into a matrix for analysis according to question topic and associated Consolidated Framework for Implementation Research domains. We used a rapid qualitative analysis approach. Providers (n = 23) widely agreed that NTO service provides valuable cancer care, particularly for Veterans facing in-person access issues across many phases of cancer treatment and survivorship. NTO services include multidisciplinary providers in patient calls and make it easier to include patient caregivers who may not be able to travel to appointments. Despite initial rapport building being somewhat challenging, providers still reported that NTO overall is of high value, particularly for rural Veterans utilizing VA-provided cancer care. Remotely delivered cancer care is an important addition to cancer care services. This may be especially important for Veterans living in rural areas or far from needed cancer care services. VA providers offer an important perspective on the role of NTO in cancer care, the barriers they face to delivering that care, and the facilitators that VA can utilize to promote the success of NTO. In an era when Centers for Medicare & Medicaid Services (CMS) shifts away from reimbursing telehealth, the VA has committed to continue such care providing a variety of patient-centered approaches.