Expanding rural access to virtual oncology supportive care.

111 Background: Despite efforts to integrate early palliative care, services for cancer patients remain scarce. This gap is pronounced in rural areas where limited access leads to unmet physical, psychosocial, and nutritional needs, and contributes to poor outcomes. Virtual models offer a promising solution, though real-world data remains limited. This study examines Iris by OncoHealth, a virtual oncology supportive care service, comparing engagement, satisfaction, and quality-of-life outcomes in rural- and urban-dwelling patients. Iris is delivered by oncology-certified nurses (OCN), oncology social workers (OSW), and oncology-specialized registered dietitians (RD). It is accessible via the web, mobile app, or phone. Methods: A retrospective analysis was conducted using electronic medical records from June 2022 to May 2025. Eligible patients were ≥18 years and enrolled in a participating health plan. The 2010 Rural-Urban Commuting Area coding system (1–3 as urban, 4–10 as rural) was used to define geography. Patient satisfaction was assessed after each encounter and calculated via Net Promoter Score (NPS) methodology. Health-related quality of life (QoL) was assessed using the 7-item Functional Assessment of Cancer Therapy–General (FACT-G7), administered monthly. Change in QoL was calculated using the within-patient difference between the first and last scores. Chi-squared and two-tailed t-tests evaluated group differences. Results: Of 1,352 enrolled, 17.6% were rural, 77.3% urban, and 5.1% unknown. Rates of clinical engagement were similar in rural and urban patients (53.8% vs. 51.1%, respectively, p = 0.50). OCN engagement occurred in 53.0% rural vs. 48.2% urban (p = 0.21); OSW in 14.7% rural vs. 16.8% urban (p = 0.50); and RD in 13.5% rural vs. 17.3% urban (p = 0.18). Mean engagement duration was shorter for rural patients (2.67 vs. 3.66 months, p = 0.013). NPS was high in both groups (83.3 rural vs. 86.7 urban, p = 0.69). Change in QoL was comparable (+0.39 rural vs. +0.44 urban, p = 0.92) and rural patients had significantly shorter intervals between first and last surveys (3.1 vs. 4.9 months, p = 0.0003). Conclusions: Virtual supportive care can improve access to high-quality, acceptable services for rural populations. Similar engagement, satisfaction, and quality-of-life improvements in rural and urban patients support the virtual model’s clinical value and potential for equitable care delivery. Further exploration and tailored strategies are needed to better understand shorter engagement, enhance access and retention, and reduce disparities in rural cancer care.