The use of telemedicine to care for cancer patients at remote sites

Abstract

6538 Background: At the BC Cancer Agency -CSI we are challenged to provide systemic cancer care to a population of 720,000 widely dispersed over 250,000 square kilometers. Video-link technology (VT) has been used at our centre since April 2004 to help provide distant care and prevent patient and physician travel. Methods: Patients gave consent for the use of VT. We prospectively collected data on patient and physician experiences as part of on-going quality assurance. We retrospectively collected the clinical data on these patients. Results: We performed 104 encounters on 100 patients between April 2, 2004 and October 4, 2006. Patient characteristics: female 62%, male 38%, average age was 66 years with a range of 28 –83. Extent of cancer was 67% curable, 31% advanced and 7% unknown. Visit type and cancer sites are shown below. Patients rated this experience very highly and the vast majority would repeat the experience rather than travel or wait several weeks to see the doctor in person. Physicians were not as satisfied as the patients; and both groups expressed a concern about the need for physical exam. In those having a consult, 54% had an exam within 60 days, and in none of these patients were the treatment recommendations changed. The majority (57%) of those consult patients that didn’t have an exam had either Stage 0 or I breast cancer or Stage II or III colorectal cancer; and it seems unlikely that physical exam would have changed management in these patients. Conclusions: We were able to deliver cancer care at distant sites with VT and patients found the experience very acceptable. There may not be a need for repeat physical exam in these patients, who had previously been examined by other physicians, prior to referral. No significant financial relationships to disclose. [Table: see text]