Oncology - Bladder, Renal, Test
Mid-Atlantic Section 76th Annual Meeting
Introduction & Objective : Urology workforce shortages in rural areas limit access to surveillance cystoscopy for patients with bladder cancer. To address this, we developed a tele-cystoscopy model in which urologic advanced practice professionals (APPs) perform cystoscopies which are interpreted in real-time by board-certified urologists at remote locations. The purpose of this study was to externally validate the newly trained APP's cystoscopy.
Methods : We have previously presented our systematic method for APP training in cystoscopy. Pilot tele-cystoscopy was performed by an APP with both an offsite UVA urologist to guide and interpret and an onsite urologist as backup support. The off-site UVA urologist evaluated the APP’s ability to perform a complete cystoscopy (observers all areas of the bladder, identifies UOs, etc.). De-identified recordings of the transmitted video were then sent in an electronic survey (Qualtrics, Provo, UT) to community urologists. External urologists were asked to evaluate the completeness of the transmitted cystoscopy.
Results : Five videos clips were reviewed by both an internal reviewer and external reviewer for completion. External reviewers generally agreed that the APP appeared to perform a complete cystoscopy identifying the essential anatomic landmarks (Table 1). The first three pairs of assessments are almost identical, and the last two pairs are very different.
External urologist evaluation of the quality of transmitted cystoscopy is feasible via electronic survey. Tele-cystoscopy may be a viable solution provide diagnoses to remote areas.