Hematology and Oncology uses of Telemedicine(Anatomy of an Outlier)

Jorge J. Nieva M.D.Billings Clinic Cancer Center

Confessions of a telemedicine doc

TOP 5 telemed users

PRISM research project 794Oncology 112Neurology 44Pulmonary 41Dietician 25

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Nieva BC doc BC doc BC doc BC doc others

Oncology Visits

Why use Telemed?

Research related visits Discussions on important decisions

requiring family participation Reducing patient travel costs to

outreach sites Monitoring labs in hematology patients Palliative care visits for patients who

have no hospice access

Research Related Visits Protocols are

complicated and inflexible

Outreach visits fall out of sequence with research visits

For NCI sponsored research, telemed is an adequate physician office visit.

Serious discussions Patients with cancer

are often elderly Many decisions are

made in conjunction with family members

Telephone calls exclude family….and lead to more telephone calls.

Patient Travel costs Outreach clinic

visits and chemotherapy are often out of sequence

Some patients drive 100+ miles to get to an outreach site.

For patients who just need to discuss labs…..

Immune thrombocytopenia Polycythemia vera Chronic Myeloid Leukemia Essential Thrombocytosis Autoimmune Hemolytic

Anemia

Cancer Outreach Clinics

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Thank You !