ASCO--After more than a year of operating a teleoncology service,
University of Kansas researchers have seen no discrepancies between
consultations conducted via interactive video and subsequent on-site
assessments. The University turned to teleoncology to better serve
patients in sparsely settled areas of the state, Gary C. Doolittle,
MD, co-director of the telemedicine service, said in his ASCO
presentation in Philadelphia.
The first teleoncology practice was established as a collaborative
effort between the University of Kansas Medical Center and the
Hays Medical Center, located 280 miles west of Kansas City. Hays
had lost its only oncologist when the telemedicine practice was
started. (An oncologist has since been recruited to the area.)
The practice includes twice weekly telemedicine clinics as well
as an outreach clinic in Hays to which Dr. Doolittle flies twice
Patients are referred to the teleoncol-ogy service by a primary
care physician. Medical information, including radiology reports
from a local radiology group, are sent to Dr. Doolittle prior
to the consult, and the actual x-rays or CT scans are transmitted
over the system during the consult, with "adequate resolution,"
The equipment includes a high-resolution color camera and two
TV monitors at each end, one showing the transmission from Hays
and the other the transmission from the University.
A history is taken in the traditional way, and the physical examination
is conducted with a nurse practitioner serving as proxy examiner.
"I direct the physical and sometimes use our far-end camera
control to zoom in on a particular area of interest," Dr.
Doolittle said. He also has available an electronic stethoscope
that enables him to auscultate heart and lung sounds over distances.
To date, Dr. Doolittle has seen 34 patients (for a total of 116
patient visits) in the Hays Clinic, with ages ranging from 23
to 96 years (average, 60). "In the beginning I was absolutely
sure that the elderly population would not adapt to this new type
of health care delivery, but, in fact, the only two individuals
who have declined to be seen on the system have been in their
30s," he said.