A Qualitative Analysis of Telemedicine Use Among Urban and Rural Patients With Urologic Malignancies.

Purpose: To better understand patient perceptions on utilizing telemedicine for the management of urologic malignancies. Materials and Methods: Semistructured interviews were conducted with patients with bladder, prostate, or kidney cancer. Interviews were conducted by phone, audio-recorded, transcribed, and deidentified. A thematic analysis was performed to examine patients' perceptions of telemedicine and its role in their care. We compared the experiences of rural and urban patients to better understand the impact that telemedicine could have and urban-rural disparities in urologic oncology. Results: We conducted 40 patient interviews. Seventy percent of patients lived in urban areas, and 30% lived in rural areas. Three primary themes were identified: (1) the benefit of telemedicine, primarily convenience, (2) variable appropriateness of telemedicine, and (3) concerns over possible impacts of telemedicine on care quality. Patients had a generally favorable telemedicine experience and appreciated that it was convenient and reduced the travel time and burden associated with getting care. However, they thought it was only appropriate in certain situations, such as routine follow-ups and to supplement in-person visits and if used incorrectly could affect care quality. Conclusions: Telemedicine has a valuable role in the care of patients with urologic malignancies. It reduces the burden of receiving care for rural patients, and optimizing its use may help reduce urban-rural disparities in outcomes. Future studies should study the impact that telemedicine has on quality.