Trends in telemedicine at a cancer center: Analyzing sustained use.

565 Background: As the pandemic transitions to a steady-state period, the extent to which telemedicine is used across different subspecialties within oncology is not well understood. This is important to identify areas in need of ongoing support, opportunities for growth and capacity for telehealth use, and to direct research efforts on patient outcomes. This study examines trends in telemedicine utilization at a large cancer center from 2021 to 2024, analyzing differences across and within medical and surgical services to identify key factors influencing long-term adoption that will inform institutional efforts around telemedicine, in-person, and hybrid approaches to care. Methods: We performed a retrospective analysis of appointment data at MSK Cancer Center. This analysis comprised two phases: a comparison of telemedicine versus in-person visit proportions from 2021 to 2024, and a detailed examination at the department and service level. Specifically, we described the variations in telemedicine adoption between medical and surgical specialties providing insights into possible factors influencing long-term utilization of telemedicine services. Results: Over the study period, MSK conducted 3,761,467 visits, with telemedicine accounting for 29.4% (1,104,526 visits). While telemedicine use declined from 40% in early 2021 to 29.3% by late 2024, certain departments and services demonstrated a strong reliance on virtual visits. For instance, Clinical Genetics and Hematology maintained high telemedicine utilization rates, 96.1% and 89.3% respectively, underscoring the suitability of virtual care for consultation-heavy disciplines. Conversely, specialties requiring physical examinations, such as Dermatology, reported significantly lower telemedicine rates. A hybrid approach was adopted for most services, with telemedicine rates ranging from 4.9% to 96.1% in 2024. Conclusions: Telemedicine has become an integral component of oncology care, with department-specific adoption highlighting the adaptability of virtual care models to meet diverse clinical needs. These findings suggest a broader shift towards a hybrid care model that seamlessly integrates telemedicine with conventional in-person visits, with certain factors likely influencing an emphasis toward one modality or the other. The study underscores the importance of understanding clinical suitability, provider, and patient preferences in optimizing telemedicine strategies. As healthcare organizations navigate the post-pandemic landscape, insights from sustained telemedicine use can inform digital health strategies, ensuring high-quality, efficient, and patient-centered care. Future research should explore policy impacts to refine telemedicine adoption frameworks. Potential policy changes such as the impending expiration of waivers in 2025 and the lack of a long-term payment model pose challenges to the sustainability of these programs.