OBJECTIVE: To determine whether neuro-oncology follow-up visits can be performed remotely using a videoconferencing system with high levels of safety and patient satisfaction.BACKGROUND: The Neuro-oncology Program at the Kaiser Permanente-Los Angeles Medical center serves the majority of Kaiser HMO patients with primary brain tumors in the Southern California region. We hypothesized that utilization of a videoconferencing system for follow-up visits would lead to high levels of patient satisfaction due to reduced travel time.DESIGN/METHODS: We installed a videoconferencing system (Cisco TelePresence EX90, Cisco Systems, San Jose, CA) in our office in Los Angeles and in a medical office building in Anaheim, CA at a distance of 35 miles. Established neuro-oncology patients from Orange County chose between in-person and remote visits. Patients were seated in an examination room and the neuro-oncologist alerted by text page. A focused history and physical examination was performed, followed by desktop sharing of clinical and laboratory data using an electronic medical record (Epic Systems Corporation, Verona, WI) and of neuroimages (Philips iSite PACS, Andover, MA). Patients completed an anonymous online 16 question satisfaction survey.RESULTS: Thirty-eight unique follow-up patients were evaluated by a single neuro-oncologist (R.G.). Sixty-nine patient visits were performed. Sixty-four visits included evaluation of neuroimaging and 23 visits included evaluation of response to ongoing chemotherapy. During 5 visits chemotherapy was started; during 5 other visits chemotherapy treatment was changed. Patients reported a high level of satisfaction with the visits (average 9.8, on a 1-10 scale). The average estimated travel time saved was 150 minutes per visit. Four surveys reported technical problems and 1 indicated a preference for an in-person visit. No adverse events could be attributed to use of the telemedicine system.CONCLUSIONS: These data suggest that neuro-oncology can be practiced safely and effectively using a telemedicine system, with high levels of patient satisfaction.
Disclosure: Dr. Green has nothing to disclose. Dr. Woyshner has nothing to disclose. Dr. Hauser Dehaven has nothing to disclose.
Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/I8-1.004?rss=1
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