e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Barriers and Enablers to Implementing Telehealth Consultations in Psycho-oncology: building on  COVID-19 experiences (#381)

Joanne Shaw 1 , Zoe Butt 1 , Lisa Beatty 2 , Laura Kirsten 3 , Haryana Dhillon 4 , Brian Kelly 5
  1. Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, Australia
  2. College of Education, Psychology & Social Work, Flinders University, Adelaide, SA, Australia
  3. Nepean Cancer Care Centre, Nepean Hospital, Sydney, State/Territory, Australia
  4. Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology , University of Sydney, Sydney, NSW, Australia
  5. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia

Aim: In response to COVID-19, telehealth was recommended across the health system. Understanding the impact of telehealth is essential to ensure psycho-oncology staff have adequate support and resources to deliver care. This study aimed to describe telehealth use in psycho-oncology during COVID-19 and investigate psycho-oncology clinicians’ attitudes to identify barriers and enablers to wider implementation.

Methods: Semi structured qualitative interviews with Australian psycho-oncology clinicians were conducted. Interviews were thematically analysed using a Framework Approach. Participants were asked to reflect on use of telehealth services at an organisational and individual clinician level, perceived impact of telehealth on quality of care and perceived barriers and enablers to wider post-COVID integration of telehealth into routine psycho-oncology care.

Results: Twenty two qualitative interviews were conducted. Participants indicated >60% of psycho-oncology consultations were delivered by telehealth, by staff (67%) with no prior training. Three key themes were identified which described the overall experience of delivering psycho-oncology services via telehealth: (1) Context - who does it work for and when does it work best; (2) Content - and Implementation – therapeutic approaches and engagement (3) Sustainability – practice recommendation and training needs. Overall clinicians expressed concerns about the impact on quality of therapy, particularly for people with more complex or serious problems. A key recommendation was the need for guidance to maximise therapy engagement and adaption of therapy approaches to telehealth platforms as well as concerns about patient selection and risk management

Conclusion: Taken together, our findings demonstrate a range of barriers and facilitators to telehealth use in psycho-oncology. While the introduction of telehealth was largely beneficial and enabled the continued psychological care of cancer patients, there are many challenges that need addressing to improve its sustainability. Psycho-oncology specific guidance for clinicians is of increasing importance to support clinicians to ensure clinical equipoise across delivery models.