The Implementation of Telemedicine within a Community Cancer Network

Abstract

Telemedicine is being used by physicians at the member hospitals of the Jefferson Cancer Network (JCN) for consultations regarding the diagnosis and management of cancer patients. The technology employed for this telemedicine system was chosen to meet three related specifications: low capital and operating cost, internal maintainability by community hospital data processing staffs, and compatibility with the existing technologic infrastructure. The solution selected is the ubiquitous desktop personal computer and associated software, and Integrated Services Digital Network (ISDN) communications links. The overall performance of this technology has been very satisfactory; ISDN communications has sufficient bandwidth for the transfer of patient data, including text reports, radiographs, and pathology slide images. The presence of the radiologist's interpretation along with the radiographic images allows the presentation of the images on these systems to be acceptable for review purposes. The video frame rates of these systems (12 to 15 frames per second) is adequate, particularly given the "talking heads" nature of the video presentations. Furthermore, the quality of the video image (resolution, size, frame rate) is secondary to the quality of the presentation of the medical information displayed and the capability for mutual annotation of the patient data during the consultation.

Telehealth in Cancer Care

“…The efficacy of telecare for cancer care has been documented in the literature since the 1990s both in the United States 41 and internationally 42 . Teleoncology approaches have included direct patient care; supportive care modalities, such as pain and nutritional consultations, tumor board presentations, and education 43 ; cancer clinical trial screening 44 ; and subspecialty oncology care 45,46 . The most recent evolution of telehealth has confirmed overall patient and clinician satisfaction with the technology 25–27 …”

Sickle cell disease telemedicine network for rural outreach

“…There appear to have been few, if any, previous reports of a disease-based telemedicine clinic network for patients with SCD. While other telemedicine networks have been described for oncology care 10,17,18 , the SCD telemedicine network is unique in providing continuous care to patients with chronic disease using a combination of telemedicine and on-site clinics at multiple locations. Outreach effort to SCD patients in rural areas is markedly enhanced with this method.…”

Telehealth: The Need for Evaluation

“…For example, London et al describe a demonstration project to improve cancer-related communications between a university cancer center and its affiliated community hospitals. 1 Their information system components include use of the World Wide Web to communicate content and eligibility information for cancer clinical trials-an approach shared and expanded upon by Afrin et al, also in an oncology context 2 -and a low-cost teleconsultation system built on commercially available teleconferencing software and Integrated Services Digital Network (ISDN) phone service.…”