Can Telehealth Offer Practical Alternatives for the Delivery of Healthcare Services?

To implement and assess the effectiveness of cancer specialists using telehealth technology to provide consultation services for patients living in rural and remote communities in BC.

Leader:

  • Brian Weinerman, MD
    BC Cancer Agency/University of British Columbia
  • Arminée Kazanjian, PhD
    University of British Columbia

To implement and assess the effectiveness of cancer specialists using telehealth technology to provide consultation services for patients living in rural and remote communities in BC.

Research Summary

Telehealth is a promising communication and information technology that holds major potential for improving delivery of health care services, information and education to people living in rural and remote communities. This includes use of telecommunication technology for medical diagnosis and patient care.

This research project was undertaken by the telehealth team at the BC Cancer Agency in collaboration with the Vancouver Island Health Authorities, and research partners at UBC and UVic, to assess use of telehealth technology to support cancer care for patients on Vancouver Island who live a significant distance from the Vancouver Island Cancer Centre in Victoria (Port Hardy/McNeill, Campbell River, Comox, Port Alberni, and Nanaimo). These and other patients from Central and North Vancouver Island comprise fully 60 percent of the patients receiving care and treatment in Victoria. In this study, the telehealth research team assessed the effectiveness of consultative services delivered by oncology specialists via video conferencing for cancer patients living in these communities. This approach could significantly reduce the burden of anxiety, expense and physical hardship that patients and their families now endure because of the need to travel long distances for cancer services.

The objectives of the study are:

Research Results

Twenty-five key stakeholders were interviewed to assess community and organizational readiness, and focus groups with consumers were held in three communities. A questionnaire was administered to determine patient and provider satisfaction with face-to-face versus via-video oncology consultations.

There were 63 new patients and 8 follow ups in the face to face and 62 follow ups and 8 new patients in the video.

Overall mean satisfaction scores for patients were identical in the video and face-to-face groups (approx. 4.9 out of 5). There was no difference in responses based on age, sex, cancer type (colorectal, lung and breast), or community location. Physicians rated overall satisfaction with face-to-face exams only slightly higher (4.9) than video encounters (4.85). Physicians who saw patients face to face often felt a physical exam was needed, but this was not the case for the same physicians who saw patients via video.

Video patients reported substantial cost savings in terms of lost wages and travel. About 20% of patients reported the cost of a visit at $200. Eighty-two patients reported a total of 27,510 kilometres traveled, in addition to approximately 7,571 kgs of greenhouse gases that could have been saved (kg/km x 0.2752006).

When face-to-face and video consults are combined, patient travel and related duress could be reduced significantly without impacting quality and completeness of care. Further research is required to determine if increased compliance with care or improved outcomes will also result. Ongoing education, training and support will be necessary to ensure this method of health service delivery. Technological infrastructure is imperative for a fully robust telehealth service to become an alternative and acceptable method of delivering quality health care service. Patients and service providers are poised to accept this method of health service delivery if there is the necessary infrastructure in place to support safe, efficient and effective care.