The objective of the pragmatic trial to test the effectiveness of an existing, ongoing clinical service, the VA National TeleOncology program (NTO), a multilevel telehealth population health management program. The primary aims are to study the intervention and determine its effectiveness on telehealth engagement, clinical quality, and healthcare cost outcomes across personal characteristics.
A Veteran
Aged 18 years or older
Newly diagnosed with lung, prostate, breast, or colon cancer within 3 months of telemedicine visit
Engaged in an oncology visit during the 36-month analysis period at a Veterans Affairs Medical Center (VAMC) location.
Veterans who have not seen any providers in the VA within the past year
Patients previously diagnosed with lung, prostate, breast, or colon cancer
Pregnant patients
Single group
National TeleOncology
BehavioralMedical and/or subspecialty oncology care offered via facility-to-facility telehealth as an alternative to usual in-person care at the nearest VA or community oncology care setting offering similar services.
Number of raw telehealth visits
Telehealth utilization among Veterans with cancer will be measured through raw telehealth visit counts.
Fraction of patients engaging in at least one telehealth visit
Telehealth utilization among Veterans with cancer will be measured by fraction of patients engaging in at least one telehealth visit.
Change in provider level Quality Oncology Practice Initiative (QOPI) score
The quality of care of the intervention will be evaluating utilizing the American Society of Clinical Oncology Practice Initiative (QOPI) performance measures. The scale consists of 26 performance measures assessed at the patient, provider, and facility levels. Each cancer care provider will have his or her patient QOPI measures aggregated together for a provider level QOPI score. Our primary interest is the difference in QOPI score by intervention condition, as estimated by the fixed-effect coefficient for the intervention indicator variable. Scores of 75% or more indicate the standard is met, scores less than 75% indicate the standards have not been met. An increase in the QOPI score indicates improvement.
Time of consultation to time of first appointment
Time to care will be measured through time of consultation to time of first appointment.
Time of consultation to time of first treatment
Time to care will be measured through time of consultation to time of first treatment.
Average total cost for cancer diagnosis, treatment and downstream HealthCare utilization
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NYU Langone Health
Lead sponsor
National Cancer Institute (NCI)
Collaborator
