Implementation of a Telehealth-Based Rapid Access Program for the Evaluation of Men Referred for Elevated Prostate-Specific Antigen.

INTRODUCTION

Delays in prostate cancer diagnostic evaluation negatively affect patient experience and may adversely affect oncologic outcomes. We evaluated the effect of a telehealth-based rapid access program (RAP) for men referred with elevated PSA on diagnostic timeliness and patient access.

METHODS

We implemented an advanced practice provider-led, telehealth-based RAP within a statewide referral center. Men referred for elevated PSA were evaluated using standardized triage and biopsy decision algorithms. Outcomes in the preimplementation (October 2023-January 2024) and postimplementation (February 2024-October 2025) cohorts were compared. Primary outcomes included time from referral to initial consultation, MRI, and biopsy. Secondary outcomes assessed patient access, including travel distance, time, and cost savings. Detection rates of Gleason Grade Group ≥ 2 were assessed as a balancing measure.

RESULTS

There were 120 men in the preimplementation cohort and 700 men evaluated through RAP. The median time from referral to (1) initial consultation decreased from 63 to 18 days, (2) MRI from 120 to 51 days, and (3) biopsy from 161 to 71 days, representing a 55.9% reduction in overall diagnostic interval (all P < .001). Detection rates of clinically significant prostate cancer were similar in the preimplementation and postimplementation cohorts (34.0% vs 39.4%, respectively; P = .06). The median round-trip travel distance and time avoided were 58 miles and 66 minutes, respectively, resulting in a median cost savings of $48.86 per patient.

CONCLUSIONS

Implementation of a telehealth-based RAP significantly reduced diagnostic intervals for men referred with elevated PSA while maintaining diagnostic quality. This scalable model demonstrates how telehealth-enabled workflow redesign can enhance timeliness and access.