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 a month.
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," he said.
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.