A Sustainable Virtual Model for Comprehensive Childhood Cancer Survivorship Care

Abstract

Background: Childhood cancer survivorship care is complex and requires access to an interdisciplinary team. The COVID-19 pandemic altered in-person care and limited support for survivors. We report here our virtually based interdisciplinary clinic model, which provides education, screening, and psychosocial assessment/interventions to childhood cancer survivors (CCSs). Method: We initiated a virtual model for up to seven interdisciplinary providers (physician, advanced practice provider, neuropsychologist, social worker, educational specialist, dentist, registered nurse, dietician, or research associate) in separate locations to see patients in an integrated clinic. The patient virtually joined one appointment and completed successive encounters as a continuous patient visit experience. Results: We maintained our patient volume with virtual survivorship visits compared to the traditional in-person model. Between 2020 and 2023, we completed 593 interdisciplinary virtual survivorship visits, sustaining our clinic numbers after the pandemic subsided. Providers reported a high level of acceptance. Virtual comprehensive survivorship visits continue to be offered at our institution. Discussion: Our findings suggest that this model is feasible, sustainable, and preferred for a subset of the CCS population. Preferred reasons reported by families included: flexibility, decreased time off work, less cost/time for travel, more comfort in their home, and avoidance of traumatic response to the hospital environment. This process paper presents a guiding framework for interdisciplinary teams to provide a virtual care option to CCSs in a more accessible, flexible format.