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

NYU Langone Health

Status: Enrolling

Conditions: Prostate Cancer Diagnosis; Colorectal Cancer (Diagnosis); Lung Cancer Diagnosis; Breast Cancer Diagnosis

Treatments: Behavioral: National TeleOncology

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06559059

5P50CA271358 (U.S. NIH Grant/Contract)

22-01448

Details and patient eligibility

About

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.

Full 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).

Enrollment: 1,800 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion 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

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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1,800 participants in 2 patient groups

VA National TeleOncology Service (NTO)

Experimental group

Description:

This arm will include 1. Veterans with a new cancer diagnosis of the lung, prostate, breast, or colon and a telehealth visit utilizing the VA National TeleOncology Service (NTO), and 2. VA health care providers and staff members participating in cancer care at NTO program medical centers.

Treatment:

Behavioral: National TeleOncology

Usual Care

No Intervention group

Description:

This arm will include 1. Veterans with a new cancer diagnosis of the lung, prostate, breast, or colon and a visit at a VA medical center location that has not implemented NTO, and 2. VA health care providers and staff members participating in cancer care at a medical center where the NTO program has not been implemented.