Development of a consensus-derived comprehensive virtual care evaluation framework in oncology
Melanie Powis, Lisa Barbera, Matthew Cheung, Randy Conrad, Mary DeVera, Annemarie Edwards, Sophia Esmail, Helen McTaggart-Cowan, Robert Olson, Stuart Peacock, Ambreen Sayani, Simron Singh, Anum Ali, Jackelyn Salmini, Saidah Hack, Monika K KrzyzanowskaIntroduction
While there has been a rapid uptake of virtual care in recent years, understanding of its impact on the quality of cancer care remains fragmented due to the heterogeneity of evaluation measures used to date and the lack of a framework to guide the work. We aimed to develop a comprehensive evaluation framework for virtual care in routine oncology practice.
Methods
We conducted separate nominal consensus groups with key informants (knowledge users, policy makers, clinicians, patients, and caregivers) to generate and prioritize lists of potential virtual cancer care measures. To identify measures from the health equity perspective, we undertook a structured consultation with an established health equity expert patient and caregiver panel. Findings were thematically grouped through a cognitive mapping exercise using a virtual whiteboard. Virtual cancer care-specific initial construct definitions were derived first from a systematic review of the literature, then refined through iterative consensus discussions and voting.
Results
Measurement priorities varied by key informant group, underscoring the need to consider the impacts of virtual cancer care from multiple key informant perspectives. The final framework included 17 constructs with definitions and operationalization considerations distributed across five domains: implementation, service, and client outcomes, with equity and cost as separate, overarching domains.
Discussion
Our findings highlight the need to consider the impacts of virtual care from multiple key informant perspectives. Our final, comprehensive virtual cancer care evaluation framework can help guide and standardize future evaluations to improve comparability, inform policy, and guide practice optimization.