Summary of live link to the Flinders Survivorship Conference by Associate Professor Sabe Sabesan.
Though teleoncology has been shown to be an effective model for providing access to specialist cancer services closer to home for rural, remote and Indigenous communities in Australia and around the world, a gap remains for survivorship care via telehealth. A plenary session at the Flinders Survivorship Conference in Adelaide explored how survivorship care can be provided through teleoncology.
A group from the teleoncology network linked up to the Adelaide convention centre to share our experiences and views on teleoncology – I (medical oncologist) joined Ms Rachael Radulovic (nurse) and three patients from the Townsville Cancer Centre and Mt Isa cancer care unit.
Via the link, current literature on teleoncology and the Townsville teleoncology models were summarised as follows.
In survivorship, the main goals are:
1. Detection of early recurrence
2. detection and management of side effects of cancer therapy and late effects
3. secondary prevention
4. addressing any fears or concerns.
All of these 4 aspects of survivorship care involve consultations and physical examinations. This can be performed using the current teleoncology models where a rural based doctor or nurse performs a physical examination as part of shared care or specialist care models. The technology used can be traditional videoconferencing equipment or web based systems. However, if imaging facilities or scopes are not available, patients have to travel to larger centres.
Currently, patients continue to travel to larger centres to access the services of many medical specialists including surgeons and gynaecologists despite widespread availability of telehealth technology. Allied health input for situations including psycho-social support, swallow assessment and lymphoedema can also be conducted through teleoncology.
Ms Rachel Radulovic, a chemotherapy and McGrath breast care nurse facilitated the Mt Isa end of the link and explained and emphasised the importance of her coordinating role in teleoncology related survivorship care. Three patients – Vanessa Denham, Theresa Braithwaite and Rhonda Harris – who received all their chemotherapy in Mt Isa under the supervision of medical-oncologists at Townsville Cancer Centre via teleoncology, shared their views and experiences. The main themes were related to feasibility and ease of doctor-patient rapport, quality of care, accessibility to specialists on demand and availability of local support closer to home through these models.
The take home message emphasised that the implementation of survivorship care through teleoncology requires system wide changes in the development of key performance indicators, allocation of resources and encouraging all health professionals to adopt this model of care.
For more information, an example of a teleoncology model of care is illustrated in the featured video RACP introduction to Telehealth.
Associate Professor Sabe Sabesan is Clinical Dean, Townsville Clinical School, James Cook University and Director, Department of Medical Oncology, Townsville Cancer Centre.