The impact of telemedicine in cancer care

Abstract

e20508 Background: The Technology Exchange for Cancer Health Network is a collaborative, multi-state effort using Telemedicine and integrated electronic health records to provide rural cancer care management. Methods: The purpose of the study was to compare quality, safety, and cost outcomes for patients receiving rural Telehealth care versus “routine” urban care. Patients with a cancer diagnosis requiring treatment for at least 1 year were eligible for the study. Telehealth patients saw their oncologist in person at rural sites for initial care and via telemedicine for about half of subsequent visits, allowing clinicians in-person clinical assessments while still taking advantage of time savings associated with telemedicine. Results: 217 patients (134 rural, 83 urban) were enrolled from 05/25/05 to 09/30/08. Patient satisfaction was high; 95 % of patients indicated their telemedicine visit was as good as or better than an in-person visit. Telemedicine patients also reported significant time and travel cost savings. Cost analysis comparing cost savings (physician travel time) with telemedicine costs (equipment, high speed lines) indicated that cost-benefit is driven by distance to rural facility and number of physician trips avoided. Telemedicine must save at least 5 hours of physician travel time per month to break even. Telemedicine was also associated with improvements in access to care. Using patient self-reported health care visit data (verified with local providers), we identified a significant decline in disparities between urban and rural patients (see Table ). Conclusions: Telemedicine offers a promising method for increasing access to oncology care that is convenient for and well-accepted by patients at reasonable costs. Our results also suggest that telemedicine facilitates access to more than just oncology care. The regular follow-up care provided through telemedicine visits may identify unmet need that might otherwise go untreated, yielding improvements in patient outcomes. [Table: see text] No significant financial relationships to disclose.