The objective of this project was to evaluate patient and physician acceptance of subspecialty oncologic teleconsultation for distant communities. Many newly diagnosed cancer patients have to travel several hours and long distances to attend specialty medical oncology consultations at our regional cancer center in Victoria, BC. Difficulties in recruiting of oncologists in Vancouver Island have prompted the search for other means to deliver subspecialty consultation closer to home. Teleconsultation seemed a possible model. Hence, 30 sequential patients with gastrointestinal (GI) malignancy referred from the Central Island region were seen after an informed consent via videoconferencing and 30 sequential patients were seen face to face in Victoria by one oncologist. Patients and the oncologist filled out a satisfaction questionnaire. The age, sex, proportion of patients who subsequently received chemotherapy, and the number of other co-morbid conditions were similar in both groups. No difference was observed in patient satisfaction whether patients were seen via videoconference or in person. However, the oncologist felt the video did not go as well as face-to-face consultation. Patients were very satisfied with teleconsultation, and it saved them hours of travel.

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The introduction of oncology telehealth in BCCSVIC/Vancouver Island Health Authority was in an ethics-approved study. Following the completion of the trial, there was a 10-fold increase in follow-up patients seen using this modality. Reluctance to see new patients through telehealth probably relates to the necessity to change the patient encounter paradigm. There is a need to develop a model where patients who are a distance from specialists concentrated in larger centers have reasonable access to the same standard of care, without incurring the time and financial burdens. Telehealth would be a part of that model.

Telemedicine, or the use of information communication technology (ICT) for medical diagnosis and patient care, is an innovative method of health service delivery. It offers opportunities and challenges for clinicians, consumers and health care organizations. In British Columbia, specialized oncology health care services are provided to cancer patients at one of the five Regional Cancer Centers of the B.C. Cancer Agency (BCCA). The burden and stress of travel for rural patients as well as the increasing demand for specialized cancer care services prompted us to explore telemedicine as an alternative health service delivery method for these patients. This article will outline a research study undertaken in partnership with the Vancouver Island Health Authority (VIHA), Provincial Services Health Authority (PHSA) and the University of British Columbia. Implementation and sustainability of a telehealth program requires an examination of organizational, health care system and technical readiness. Barriers to uptake include human factors and infrastructure requirements. A systematic approach optimizes the successful implementation of a telehealth program.