Determining the Value-on-Investment of Provider-to-Provider Virtual Consultation for Cancer Care

Abstract

BACKGROUND:  Access to high-quality cancer care in the United States remains a challenge in part due to a geographic mismatch between patients with cancers and the oncologic specialists best able to serve them. There is therefore an urgent need to develop communications strategies that allow oncologists to determine which patients might benefit from referral for subspecialty cancer care, and to allow subspecialists to guide care remotely when patients are unable or unwilling to travel. Unfortunately, virtual consultation between clinicians has been understudied, and likely underutilized, in cancer care.  Health systems may be hesitant to implement a virtual consultation program without data on such a program’s value.    RESEARCH DESIGN:  In this article we outline a framework for calculating the value on investment (VOI) for a provider-to-provider virtual consultation framework to improve geographic access to cancer care. For each element of VOI, we suggest specific outcomes that health systems might utilize to determine the value of implementing virtual provider-to-provider consultation.   RESULTS:  Elements of VOI include: direct and indirect revenue, institutional halo effect, hospital-based care, infrastructure considerations, subspecialty resource utilization, continuity of care, patient-reported outcomes, clinical trial enrollment, and program monitoring and quality improvement.   CONCLUSION:  Implementation of virtual consultation between general and subspecialty oncologists offers health systems the potential for substantial value on investment, largely through improving clinical outcomes by optimizing the resources involved in patients’ cancer care.