Abstract
BACKGROUND: Telemedicine expanded rapidly during COVID-19 and may reduce logistical burdens for oncology patients. Evidence on patient satisfaction within Brazil's public health system (SUS) remains limited. Here, the authors evaluated the feasibility of telephone-based telemedicine for gynecologic oncology follow-up. METHODS: The authors conducted a cross-sectional mixed-methods pilot study at a public gynecologic oncology clinic in São Paulo (March 2023 - February 2024). Established patients attending follow-up visits that did not require a physical exam were included; new patients were excluded. Telemedicine visits were conducted by phone. The PSQ-18 was translated and adapted to the SUS context (two cost items removed: 16-items total). Item-level satisfaction is presented for in-person and telemedicine visits. Semi-structured interviews explored experiences and barriers. RESULTS: From 54 eligible patients, 18 were enrolled (in-person = 10; telemedicine = 8). Item-level PSQ-18 responses indicated high satisfaction in both groups, though direct comparison is limited by baseline differences and limited statistical power. Regarding logistics, the telemedicine group reported low rates of out-of-pocket expenses (1/7, 14.3%) and missed work (0/8), whereas these burdens were frequently reported in the in-person group (77.8% and 33.3%, respectively). Physicians reported full goal achievement (100%) and patient understanding (100%) for telemedicine encounters. Interviews highlighted convenience, reduced travel/time costs, and ease of use; barriers included technology access, digital literacy, and lack of visual cues in audio-only calls. CONCLUSIONS: In this SUS setting, telephone-based telemedicine for appropriately selected follow-up visits was feasible. Implementation should address digital inclusion and clarify indications that require in-person assessment. Larger studies should validate telemedicine-specific satisfaction measures and assess downstream outcomes.