Medical oncology services in cyber space: Benefits of the Townsville teleoncology project.

Abstract

e16545 Background: Current models of rural outreach cancer care are inadequate since patients and specialists spend significant amount of time in costly long distance travels for consultations and treatment. Clinics conducted using videoconferencing technology eliminates unnecessary travel while providing subspecialist services closer to rural homes. Townsville Cancer Centre (TCC) in Queensland, Australia provides all its medical oncology services including supervision of chemotherapy delivery, in patient consultations and ward rounds exclusively on videoconferencing for most rural cancer patients in their health districts. Distances between TCC and rural towns range from 400 to 1200 km. Overall clinic model and patient satisfaction are described elsewhere. Clinics are run weekly, ward rounds and in patient consultations are conducted on demand. Aim of this report is to describe the benefits of our model of care. Methods: Data on clinics conducted between May 2007 and December 2010 was extracted from the oncology information system of the TCC. Results: A Total of 150 patients were reviewed in 609 consultations in 44 months. Median age was 58 (20-86) and males were 46% and females 54%. 24 patients were from indigenous communities. Last 77 patients were cared for without seeing in person. Most common cancer types were breast (37%), colorectal (21%) and lung (22%). Total of 81 patients received a total of 431 cycles of chemotherapy. Examples of chemotherapy regimens include TAC, BEP, FOLFOX, methotrexate infusion etc. One patient died of severe pneumonia after one cycle of capeciatbine, one patient suffered a stroke after 4 cycles of EOX and one suffered non fatal cardiac arrest after herceptin. Other side effects and admission rates were similar to TCC figures. 10 patients were seen urgently and received urgent chemotherapy, thus avoiding transfer to TCC. 6 admitted patients were seen on regular ward rounds during their in patient admission. Conclusions: Provision of comprehensive medical oncology services via videoconferencing is feasible and is a safe and efficient model of care for rural, remote and indigenous patients of North Queensland. Given its many benefits, our model could become part of standard practice.