A cross-sectional survey of patient attitudes towards telemedicine in head and neck surgical oncology

Objective: To investigate patient attitudes towards desire for and barriers to utilizing telemedicine visits for head and neck oncology care. Methods: This is a retrospective analysis of data from cross-sectional survey responses collected via prospectively administered questionnaire to 616 adult patients during their clinical visit to a tertiary care head and neck surgical oncology clinic. Responses to questions investigating interest in telemedicine and potential barriers were collated with patient demographics, measures of rurality, and insurance status. Interest in telemedicine appointments was the assessed primary outcome. Results: Of 616 survey respondents, 315 (51 %) indicated interest in telemedicine visits. Limitations in access to technology (17.5 %) and lack of reliable internet connection (13.14 %) were identified as key barriers to telemedicine use. Lack of interest in telemedicine was associated with older age (OR 0.97 [95%CI 0.96–0.98]), governmental insurance (0.43 [0.31–0.60]) and, retired work status (0.48 [0.33–0.69]). Women (1.43 [1.04–1.97]) and patients who reported access to compatible electronic devices (41.05 [14.88–113.20]) and reliable internet connection (20.94 [8.34–52.60]) were more likely to be interested in telemedicine appointments. Respondents also indicated preference for a “hands on” examination over telemedicine appointments. Conclusion: Nearly 1 in 2 patients evaluated in a tertiary care head and neck surgical oncology clinic expressed reticence regarding telemedicine for clinical visits. Limited access to technology platforms and unreliable internet remain key concerns for these patients. Understanding the needs and attitudes of specific patient populations may be important for organizations pivoting to telemedicine platforms to ensure equity in healthcare access. Level of evidence: Retrospective analysis of prospectively collected cross-sectional survey.