An Evaluation of the Provision of Oncology Rehabilitation Services via Telemedicine Using a Participatory Design Approach

The COVID-19 pandemic has fundamentally impacted the delivery of healthcare services globally. In line with UK government guidelines on social distancing, the use of telemedicine was implemented to facilitate the ongoing provision of cancer rehabilitation. We sought to evaluate and co-design telemedicine services to meet the complex needs of our patients and carers at a tertiary cancer centre. Experience-based co-design methodology was adapted to include virtual methods. Staff members (n = 12) and patients (n = 11) who had delivered or received therapies services at our UK cancer centre since March 2020 were recruited to take part in one-to-one virtual interviews. Patient interviews were video recorded, analysed and edited to a 30-min “trigger film”. Patient and staff virtual events were undertaken thereafter. A joint virtual patient and staff event occurred. Staff and patients watched the trigger film and as partners, agreed areas for change and developed groups for service co-design. Positive aspects regarding telemedicine provision were highlighted including reduced financial and time burden on patients, and increased flexibility for both staff and patients. The key concerns included digital exclusion, safety, communication and patient choice. Four co-design groups have been established to enact changes in these priority areas. Using a participatory design approach, we have worked in partnership with patients and staff to ensure the safe, acceptable and effective delivery of rehabilitation services with integrated telemedicine.