Budget poor, but outcomes rich: How to set up tele-assisted systems in a regional and rural cancer center.

Abstract

4 Background: Tyranny of distance in Australia has motivated oncologists to try innovations in oncology care to improve cost efficiency, access, and compliance. This is often done with little budget availability as health funds are metrocentric. The aim is to bring novel approaches to utilisation of oncology care and show its applicability to most countries even with financial constraints. Methods: Mt Gambier Hospital is a regional hospital in South Eastern South Australia (SE SA). The data collected from clinics was commenced in January 2016, to gain knowledge of epidemiology of cancer in the region, and numbers of patients seen. Despite gold standard cancer care being performed in consultations which are face-to-face, we rolled out telemedicine consultations. We also, implemented a Survivorship Care Model, and entered into a Teletrials Project which sets up a regional trials centre with support from a tertiary hospital, Flinders Medical Centre. Results: Telemedicine has been made in Mt Gambier Hospital’s cancer service a part of every day practice to save patients from unnecessary travel. From January 2016, until May 2019, there were 812 consultations with nurse practitioner, 2542 consultations with consultant in clinic, and 246 telemedicine consultations. Survivorship clinic has been implemented according to South Australian Framework for Survivorship with no extra funding. Since 2017, 49 patients were seen with curative therapy. A re-alignment of appointment scheduling will see 6 patients in the next 2 months, thus increasing clinic potential. Teletrials Project was born from collaboration with Flinders Medical Centre, and gained funding by Beat Cancer South Australia. We are now entering into final stages of Governance agreement for our 1st trial, 18 months from commencing the project. Since then, we also got 2 more collaboration grants from Beat Cancer SA. Conclusions: With limited resources, regional cancer centres are able to maximise their patient outcomes by applying novel strategies. These novel ways of doing things, may be able to be implemented on either existing budgets or through collaboration with metropolitan cancer centres to attract financial grants to improve patient outcomes.