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DOI: 10.1200/jco.2012.30.34_suppl.288 Journal of Clinical Oncology - published online before print December 1, 2012
PMID: 28147189
Telehealth for oncology genetic counseling: An Idaho experience.
Abstract
288
Background: Access to qualified genetics specialists continues to be a barrier for patients in rural settings. Our institution aimed to develop a proof-of-concept telehealth program that supports the vision of transforming the way healthcare is delivered specific to Idaho. Methods: Based on a needs assessment with 40 direct caregivers the program was designed to eliminate inconsistency and variation through the system and expand the specialty care footprint from the tertiary care hospital. To gain traction, specific areas (genetic counseling and nutritional counseling) were identified that could move forward with telehealth. This small-scale implementation could be rapidly executed using few system resources while providing feedback for future refinement and expansion. Technology needs included, Microsoft Lync, a HD web camera, USB speaker/microphone, dual monitors, and a document camera to be added to workstations for the provider. A transportable cart with computer and dual monitor workstation was assembled for the outreach site with the same technology components. The metrics chosen to track the benefits of this service included: provider travel time and costs, elapsed time from referral to first scheduled appointment, comparison of patient volumes, and patient satisfaction. Satisfaction measures were collected by written questionnaires and interviews with the patient. Results: During a 3-month period 23 genetic counseling appointments were conducted by telehealth. This resulted in a savings of $1050.63 in mileage and travel wages and 13.5 travel hours. Wait times for appointments dropped from 23 days to 16 days, and appointment volumes increased from 6/month to 8/month. Access to services increased from 8 hours per month to 16 variable hours per month with the availability of immediate needs appointments. Patient scores (N=12) demonstrated “Excellent” ratings (5/5) in the following: 83% satisfaction using the telehealth cart, 83% likelihood to use telehealth again, and 92% recommend telehealth to a friend. Conclusions: Improved convenience, access, and cost savings while providing high quality care were maintained using telehealth. Expansion of the program to another outreach site has already been approved by leadership.
