The Anatomy of a Hybrid InPerson and Virtual Sexual Health Clinic in Oncology - Abstract
Introduction: Sexual health is compromised by the diagnosis and treatment of virtually all cancer types. Despite the prevalence and negative impact of sexual dysfunction, sexual health clinics are the exception in cancer centers worldwide. Consequently, there is an exigent need for effective, efficient, and inclusive sexual health programming in oncology. This paper describes the newly developed Princess Margaret Cancer Centers (Toronto, Canada) Sexual Health Clinic (SHC) utilizing an innovative, hybrid model of integrated in-person and virtual care. The SHC is dedicated to assisting patients/couples in re-establishing optimal sexual function, satisfaction, and interpersonal intimacy.
Materials and Methods: The SHC evolved from a fusion of the Prostate Cancer (Sexual) Rehabilitation Clinic at Princess Margaret (in-person) and the Movember TrueNorth Sexual Health And Rehabilitation e-Clinic (virtual) for prostate cancer patients. This hybrid care model was adapted to include six additional cancer sites (Cervical, Ovarian, Testicular, Bladder, Kidney, and Head and Neck) with plans to expand to all cancer sites. The SHC is theoretically founded in a biopsychosocial framework and emphasizes interdisciplinary intervention teams, active participation by the partner, and a broad-spectrum medical, psychological, and interpersonal approach. The launch of the SHC utilized a Hybrid Type 3 implementation methodology to ensure seamless integration into the patient workflows across the cancer sites of a high-volume cancer center.
Results and Discussion: The hybrid model of care has the potential to provide highly personalized care while conserving limited resources. Virtual visits are tailored to patients based on biological sex, cancer type, and treatment type. This process has resulted in 32 unique patient streams. The SHC virtual care is facilitated by highly trained sexual health counselors via chat, telephone, or videoconference. The sexual health counselors provide an additional layer of personalization and a “human touch” to the virtual clinic space. The in-person visits complement virtual care by providing comprehensive sexual health assessment and sexual medicine prescription. To inform quality assurance and evaluate effectiveness, relevant physical, psychological, and interpersonal outcomes will be serially collected via the SHC virtual portal over 12 months post-treatment. Additionally, analysis of 20 stakeholder interviews (HCP, clinic staff, and patients) will guide the SHC implementation into patient workflow.
Conclusion: The SHC is an innovative care model which has the potential to close the gap in sexual healthcare during a time of limited healthcare funds/resources. The SHC is designed as a transferable, stand-alone clinic which can be shared with cancer centers across North America.