Skip to main content


Technological Knowledge for Telehealth Services Among Patients With Cancer

May 14, 2021

Jeremie Lever, MD, PhD, O'Neal Comprehensive Cancer Center, University of Alabama, discusses results from an analysis evaluating the knowledge of and access to technology for telehealth services among patients with cancer.

These results were presented at the 2021 virtual National Comprehensive Cancer Network (NCCN) Annual Conference.


Hello, everyone. Thanks very much for being here today. It's a privilege, and thank you to the Journal of Clinical Pathways. My name's Jeremie Lever. I'm an MD/PhD student finishing up my program at the University of Alabama at Birmingham Medical Scientist Training Program.

I did this work with Dr Sushanth Reddy in the Department of Surgery at UAB. It's entitled "Telehealth is here—Are patients ready for it? An analysis of technological knowledge in cancer patients."

I want to thank Ahmer Irfan, the resident mentor on the project, Dr Fouad, Dr Sleckman, and then faculty from Department of Surgery, Dr Rose, Dr Wang, and Dr Chu. We wanted to try to understand, at the O'Neal Comprehensive Cancer Center, are our patients equipped to make full use of the telehealth technology that's becoming available, video visits, etc.?

Telehealth is a technology for delivering health care that's been available for some time, especially using phone visits. Now, with the improvement in electronics and internet access, video visits are becoming more possible. With the COVID‑19 pandemic, there was a huge increase in implementation for video visits and for telehealth.

However, there is a concern that certain patients may not have the knowledge necessary, or they may be from disadvantaged backgrounds, socioeconomic status. Potentially, there are other demographic factors that may contribute to being poorly equipped to take full advantage of telehealth.

Our objective in this study was to assess technological knowledge among cancer patients at the O'Neal Comprehensive Cancer Center at UAB. We wanted to determine whether certain demographic factors would be associated with decreased technological knowledge. We also wanted to study their Internet access.

This was a single‑center cross‑sectional survey study. We looked at demographic factors. In order to assess their knowledge, we used a 10‑question quiz regarding terminology about computers and the Internet. We did a statistical analysis, a univariable ordered logistic regression, and for multivariable, we used the mixed‑model ordered logistic regression.

We had 344 participants, 70% were women. We had good representation of racial and ethnic minorities. We had a broad distribution of education levels, including less than 35% only reached a level of high school or lower.

We had some patients that did not have a smartphone, so a range of different types of cell phone ownership as well as a range of different internet access. What we found is that technology knowledge decreased with increasing age. Knowledge was lower in persons with a non‑White race. Decreased income was associated with lower technological knowledge.

A lower level of highest education reached was associated with decreased technological knowledge. Also, non‑smartphone cell phone type was associated with decreased knowledge.

These are things that you might have predicted, but it's nice to have data to support that these are persons that may be at risk of not being able to take full advantage of telehealth and video visits and they might need extra support.

In conclusion, nearly one‑third of cancer patients in our study didn't have adequate Internet access for video visits. There was significant disparities in technological knowledge among cancer patients, which were associated with demographic characteristics such as age, race, and education level.

This study, I hope, will be a call to action to not assume that our patients are going to have the knowledge that they need in order to take full advantage of video visits and telehealth right now.

They may need that extra support. They might need some education or some other additional intervention. Hopefully, this can serve as a roadmap for identifying patients that may be at risk that might need that extra support.

Also, hopefully, it's a first step for future studies to expand this to more centers, increase the number of patients, and hopefully, to try an intervention and see how the intervention works for making sure that there are not patients that are left behind when it comes to taking advantage of this new method for healthcare delivery.

With that, I'll conclude. I want to say thank you to my mentor, Dr Sushanth Reddy, Dr Ahmer Irfan, Dr Thomas Wang, Dr Bart Rose, Dr Dan Chu—all from Department of Surgery—our department chair, Dr Herb Chen, and my wife, Jacelyn Lever.

Thank you to the O'Neal Comprehensive Cancer Center and the UAB Medical Scientist Training Program. Thank you.

Lever J M.P., Irfan A, Fouad M, et al. Telehealth is Here—Are Patients Ready for It? An Analysis of Technological Knowledge in Cancer Patients. Presented at: the NCCN 2021 Virtual Annual Conference; March 18-20, 2021. Abstract HSR21-059.

Dr Lever reports no relevant financial relationships.

Back to Top