Virtual Second-Opinion Delivery for Oncology Patients.

Shah AP, Shi S, Sun TY, Patel MI, Shah SA. Virtual Second-Opinion Delivery for Oncology Patients. JCO oncology practice. 2025 Aug 1; 21(8):1118-1123, DOI: 10.1200/OP.24.00392.

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Abstract:

PURPOSE: Patients with cancer face increasing difficulty securing access to timely, quality oncologic care. A virtual consultation program at a tertiary academic center could eliminate physical barriers while providing treatment recommendations that could be executed locally. METHODS: We evaluated an to increase access to expert care via a cloud-based platform through Included Health. This program was open to any patient globally who had a local treating physician. Patient records were compiled and sent to a disease expert at Stanford Healthcare. A report detailing an assessment and treatment recommendation was then returned within 3 days. We analyzed the characteristics of the patient base and the frequency with which treatment change was recommended. RESULTS: Between November 2018 and August 2020, 657 patients participated in the program. The majority of patients were female (58.4%) with a mean age of 60 years. A majority lived out-of-state (62%, with 24.7% of total patients from outside the United States) and had advanced disease (77.2% diagnosed at stage III or IV). Breast cancer was the most common diagnosis (24.7%). Physicians providing the virtual service were primarily medical oncologists (67.6%) and reported to have recommended a treatment change in more than half of the cases reviewed (53.8%). A treatment change was most often recommended for patients with stage II disease (64%), and least often for stage I and III disease (both 45%). CONCLUSION: To our knowledge, this is one of the first studies to describe patients who use virtual second-opinion programs for oncology, showing that more than half of the patients were recommended to have a treatment change. Although patients most often had advanced disease, those with stage II disease most often received a treatment change recommendation.