Exploring tele-oncology alternatives to face-to-face care in low-income settings

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Published: 17 Dec 2014
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Dr Sabe Sabesan - Townsville Cancer Centre, Queensland, Australia

Dr Sabesan talks to ecancertv at the UICC World Cancer Congress 2014 about the continuing role of tele-oncology in cancer care.

Tele-oncology initiatives are low-cost practical alternatives to face-to-face care, Dr Sabesan says, particularly in rural, remote and indigenous communities.

The main purpose of the tele-oncology is really to provide specialist cancer services closer to home for people from rural, remote and indigenous communities so that they don’t have to spend their time on travelling. In terms of the effectiveness of tele-oncology we look at patient satisfaction, health professional satisfaction, what is feasible through tele-oncology models, whether it is safe and whether it is cost effective.

In terms of patient satisfaction there are many small studies but the consistent finding is that patients welcome these models for the benefit of the travel and inconveniences provided that the care we provide is up to standard. So there are no shortcuts with tele-oncology, we still have to make sure that the quality and safety is there. Health professionals welcome this model again because this is the first time they are able to connect to the tertiary centres for advice and support and mentoring so that the care is continuous. So there is a continuity of care for that.

Also, in terms of what is feasible, it’s really up to the capacity of the centre. So if you have the full capacity to provide an oncology service closer to home then you can provide everything. For example, in our centre we have a large rural town called Mount Isa in North Queensland. The tele-oncology has replaced face-to-face care because over time we have made sure that resources in Mount Isa were adequate enough to provide all the services. The only thing we provide is specialist support via video link on demand and routinely as well.

Always there is a concern about safety and we have compared the safety profile of patients having chemotherapy in the Townsville Cancer Centre, that is a tertiary health centre, with patients having chemotherapy in the rural centres. We found that dose intensity and the safety profiles are exactly the same. So we are convinced and reassured that the quality is not compromised.

The other major thing is when the travel is avoided and savings are accrued for the health system now the health system has the capacity to reinvest those savings and to really build the system rather than wasting it away in travel and carbon footprint. So in our mind we are satisfied that tele-oncology models are feasible and they work and it should be part of routine practice and standard of care.

In terms of cost of setting up, obviously there is a cost, nothing comes free. You can use Skype to share the patients with the general practitioners, so that’s a cheaper option. But if you are providing a comprehensive service then you require a traditional video conferencing system. At the end of the day, our cost analysis studies have shown that by stopping travel the overall benefit will outweigh the cost of establishment.