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Evaluating the Implementation of a Comprehensive Multilevel Virtual Oncology Program Among Veterans Diagnosed With Lung, Colorectal, Prostate, and Breast Cancers in the US Department of Veterans Affairs

Clinicaltrials.gov ID: NCT06559059
db-list-check Status RECRUITING
b-loader Phase
b-people Age ≥ 18 Years
b-bullseye-arrow Enrollments 1800

Conditions

Lung Cancer Diagnosis, Colorectal Cancer (Diagnosis), Prostate Cancer Diagnosis, Breast Cancer Diagnosis

Summary

The purpose this 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 levels of Social Determinants of TeleHealth (SDTH) with the goal of promoting health equity.

Detailed Description

Study staff will use the Veterans Health Information Systems and Technology Architecture (VistA), the VA health information technology system, to identify eligible patients at VA sites based on listed inclusion and exclusion criteria. Patient records will be observed of Veterans with a new cancer diagnosis of the lung, prostate, breast, or colon and a telehealth visit utilizing the VA National TeleOncology Service (NTO).

Locations

5 locations Found with status Recruiting

Status

  • RECRUITING

Central Contacts

Principal Investigator

  • Danil Makarov, MD, MHS

Status

  • RECRUITING

Central Contacts

Principal Investigator

  • Danil Makarov, MD, MHS

Status

  • RECRUITING

Central Contacts

Principal Investigator

  • Danil Makarov, MD, MHS

Status

  • RECRUITING

Central Contacts

Principal Investigator

  • Danil Makarov, MD, MHS

Status

  • RECRUITING

Central Contacts

Principal Investigator

  • Danil Makarov, MD, MHS

Eligibility Criteria

Patients Inclusion Criteria:

1. A Veteran
2. Aged 18 years or older
3. Newly diagnosed with lung, prostate, breast, or colon cancer within 3 months of telemedicine visit
4. Engaged in an oncology visit during the 36-month analysis period at a Veterans Affairs Medical Center (VAMC) location.

VAMC Providers and Staff Inclusion Criteria:

1. Provider or staff member at one of the VAMC locations including physicians, nurse practitioners, physicians' assistants, and nurses caring for Veterans
2. Providers or staff members having helped provide care for at least 5 Veterans with cancer in the previous 6 months at a VAMC location

Patients Exclusion Criteria:

1. Veterans who have not seen any providers in the VA within the past year
2. Patients previously diagnosed with lung, prostate, breast, or colon cancer
3. Pregnant patients

VAMC Providers and Staff Exclusion Criteria:

1. Providers or staff members who do not help treat Veterans with specified cancers in oncology at the VA

Study Plan

Veterans

Veterans aged 18 years or older newly diagnosed with lung, colorectal, prostate or breast cancer. Patient records will be observed of Veterans with a new cancer diagnosis of the lung, prostate, breast, or colon and a telehealth visit utilizing the VA National TeleOncology Service (NTO).

VA health care providers and staff members

VA health care providers and staff members participating in cancer care at NTO program medical centers, including physicians, nurse practitioners, physicians' assistants and nurses.

Outcome Measures

Primary Outcome Measures

Number of raw telehealth visits

Time Frame: Post-NTO implementation (up to 3 months)

Fraction of patients engaging in at least one telehealth visit

Time Frame: Post-NTO implementation (up to 3 months)

Secondary Outcome Measures

Change in provider level Quality Oncology Practice Initiative (QOPI) score

Time Frame: Pre-implementation, post-NTO implementation (up to 3 months)

Time of consultation to time of first appointment

Time Frame: Pre-implementation, post-NTO implementation (up to 3 months)

Time of consultation to time of first treatment

Time Frame: Pre-implementation, post-NTO implementation (up to 3 months)

Average total cost for cancer diagnosis, treatment and downstream HealthCare utilization

Time Frame: Post-NTO implementation (up to 3 months)

Timeline

  • Last Updated
    November 4, 2024
  • Start Date
    August 19, 2024
  • Today
    May 12, 2025
  • Completion Date ( Estimated )
    January 1, 2027

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