Implementation and evaluation of a virtual long-term follow-up clinic for allogeneic stem cell transplant survivors using the RE-AIM framework.
562 Background: Long-term follow-up (LTFU) care is essential for survivors of allogeneic hematopoietic stem cell transplant (allo-HCT). Travel distance to specialty centers can pose a significant barrier to accessing care. We implemented a virtual LTFU clinic at a tertiary cancer center to reduce these burdens and optimize service delivery. Methods: This initiative used the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) to evaluate a virtual LTFU clinic for allo-HCT survivors. Eligible patients were ≥2 years post-transplant, clinically stable, off immunosuppression, and followed by a primary care provider. From October 21, 2024, to March 10, 2025, patients were screened and invited to transition to virtual care via MSTeams or phone. Requisitions for required bloodwork were emailed in advance, and results were integrated into the EMR and reviewed with patients during the visit. A Patient Flow Coordinator facilitated scheduling and preparation. Patient-reported experience measures were collected through REDCap surveys pre- and post-intervention. Results: Patients reported improved satisfaction and greater involvement in care. Virtual care eliminated perceived barriers and was particularly valuable for those living far from the hospital. Key results are summarized in the table. Of the 77 eligible patients who declined virtual care, common reasons included: pre-existing plans to be in Toronto, preference for in-person visits, or having concurrent medical appointments. Notably, 13 (28.9%) of those who declined expressed interest in participating in the virtual program in the following year. Conclusions: Virtual LTFU care is a feasible and effective model for allo-HCT survivors, particularly in settings where distance impedes access. In comparison to baseline level, patients reported improved satisfaction, a greater sense of involvement in care, and fewer logistical challenges. With proper infrastructure, communication, and EMR integration, virtual care can enhance accessibility, equity and quality in long-term transplant survivorship. Measure Value Patients screened 203 Eligible for virtual care 125 (61.6%) Completed virtual visit 48 (38.4% of eligible) Mode of visit: MS Teams 33 (68.8%) Mode of visit: Phone 15 (31.3%) Avg. patient distance to hospital 140.8 km (range: 4.7-1543 km) Reported no barriers (intervention) 100% Felt involved in care (median score) 5 Satisfied with time spent (median score) 5
Authors
- Neesha C. Dhani (ORCID: https://orcid.org/0000-0002-0410-6932)
- Alastair Forbes (ORCID: https://orcid.org/0000-0001-7416-9843)
- Lisa Tinker
- Iqra Ashfaq (ORCID: https://orcid.org/0000-0002-7545-2090)
- Hilary Weatherby
- Tommy Alfaro Moya (ORCID: https://orcid.org/0000-0003-4171-4678)
- Auro Viswabandya (ORCID: https://orcid.org/0000-0001-9690-4669)
- Jonas Mattsson (ORCID: https://orcid.org/0000-0002-2163-6644)
- Alyssa Macedo
- Vanessa Loiacono
Institutions
- University Health Network (CA)
- Cancer Care Ontario (CA)
- Princess Margaret Cancer Centre (CA)
Publication Details
- Journal
- JCO Oncology Practice
- Published
- 2025-10-01
- DOI
- https://doi.org/10.1200/op.2025.21.10_suppl.562
- Primary Topic
- Cancer Genomics and Diagnostics
- Type
- article
- Field-Weighted Citation Impact
- 0.00