Tele Oncology for Cancer Care in Rural Australia
2011; Linguagem: Inglês
10.5772/17112
Autores Tópico(s)Advances in Oncology and Radiotherapy
ResumoTelemedicine Techniques and Applications 290 addition, these models are expensive because of cost of travel and accommodation for patients and their families and specialists.This calls for alternative ways of consulting and treating patients from smaller rural centres.Care of cancer patients using videoconferencing is an attractive model to satisfy this call.This technology allows patients, doctors, health workers like nurses and other allied health practitioners and family members to see each other while discussing management options unlike telephone consultations.Centres with established teleoncology services include Kansas, USA; British Columbia, Canada ; Townsville, Australia and many others around the world (Doolittle et al,2001;Taylor et al' 2007; Sabesan et al, 2009). Models of teleoncology outreach careTechnologies in telemedicine like videoconferencing can be used for various purposes in cancer care.These include 1. Discussion between health care professionals about cases in multidisciplinary meetings, 2. Consultation of patients by allied health professionals, 3. Consultations by medical oncologists, radiation oncologists, palliative care physicians and haematologists for ambulatory patients and inpatients in rural hospitals. Townsville Cancer Centre modelTownsville Cancer Centre, a comprehensive cancer centre, is located in Townsville in Queensland, Australia and is the tertiary referral centre for a population of 650,000 in the North Queensland.Over the last four years to improve the rural access to specialist medical oncology services, department of medical oncology of the Townsville Cancer Centre has been using videoconferencing technology to oversee the management of medical oncology patients from rural and remote towns of the Townsville and Mt Isa Health Service Districts, approximate area of 1200 x 1200 kms.Initially patients were seen face to face for the first consultation, with subsequent video link consultations and treatment performed in Mt Isa or in alternative nearby towns.In the last 12 months the role of videoconferencing in the Townsville Cancer Centre has expanded, with patients now managed exclusively via videoconferencing from the first consultation to treatment and follow up.Videoconference consultations are conducted on a weekly basis and patients are allocated a time slot in routine medical oncology clinics, although urgent cases are seen anytime.Prior to initial consultations, informed consent is obtained from patients and individuals declining to be seen via video link would be given the option of travelling to Townsville.In Mt Isa, at the receiving end of the video link, patients and their support persons are joined by a chemotherapy competent nurse, senior medical officer, and allied health workers.Patients are examined by the attending doctors during consultations.If a patient has had a recent CT scan (computer tomography) then physical examination is not performed, except for checking vital signs.Treatment decisions and chemotherapy regimes are decided by the medical oncologists and are administered in Mt Isa by chemotherapy competent nurses, supervised by the local medical team.Any dose modifications are made by the specialists and patients needing urgent chemotherapy for aggressive disease receive their chemotherapy in Mt Isa without delay.Patients who are severely unwell, due to their primary diagnosis or due to treatment adverse effects, are seen more frequently via video link while they are in patients, with the option of transfer to the Townsville Hospital.For other towns in the health services district, where administration of intravenous chemotherapy is not feasible, a nurse and sometimes doctors accompany the patients and www.intechopen.com
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