Telehealth Delivers More Cancer Services Closer to Home

Cancer patients in rural and remote areas can access cancer services closer to home thanks to tele-oncology models of care developed by Townsville Hospital and Health Service in partnership with James Cook University.

For many cancer patients in rural and remote Australia, accessing treatment often involves travelling long distances to a major regional or metropolitan hospital for what might be only a five-minute consultation with their oncologist or a 30-minute weekly chemotherapy session. For patients already experiencing the symptoms of cancer and the side effects of chemotherapy, this long-distance travel can be financially, emotionally and physically draining.

Motivated by this additional hardship experienced by rural and remote cancer patients, Townsville Hospital oncologist Professor Sabe Sabesan, in conjunction with health systems researchers at James Cook University, developed new telehealth models of care to bring specialist cancer services to rural hospitals.

The North Queensland Teleoncology Network allows rural and remote cancer patients to access specialist cancer care via telehealth. In this model, consultations with an oncologist are performed via videoconference with support from local doctors, nurses and allied health professionals. Patients who are fit for chemotherapy receive treatment locally with the help of suitably trained nurses.

Prof Sabe Sabesan

The remote supervision of chemotherapy has been demonstrated to be as safe as traditional models of chemotherapy and high satisfaction with the process has been demonstrated among health care providers and cancer patients, including Indigenous cancer patients.

Professor Sabe Sabesan is confident of the safety and efficacy of the telehealth model.

“What we have found is that many types of chemotherapy can be delivered in rural centres by tele-oncology models of care without compromising safety and quality of care,” he said.

“Through the use of telehealth, rural patients can gain access to selected chemotherapy and other complex cancer therapies similar to that of urban patients without the need to travel to a major centre.”

Mount Isa Base Hospital cancer clinic nurse unit manager Nicole Williams agrees.

“Telehealth helps bridge the health inequalities between the city and country. Our patients are grateful that they are able to access high quality, safe and effective cancer treatment in their own region, without having to fund and plan for long-distance travel,” said Ms. Williams.

The North Queensland Teleoncology Network has made a significant impact in the region.

Between 2014-18, the Townsville Hospital and Health Service conducted 9,542 consultations using telemedicine and delivered 842 cycles of chemotherapy through remote supervision models. Between 2014-16, 62 patients, of which 12.9% identified as Indigenous, received 327 cycles of chemotherapy at Cooktown, Thursday Island, Weipa, Bowen, Hughenden and Ingham.

Professor Sabe Sabesan says the model also saves money on patient travel – savings which  can be reinvested in rural health services. By reducing travel between Mount Isa and Townsville, for example, enough money has been saved to recruit a trainee oncology doctor in Mount Isa.

The success of the North Queensland Teleoncology Network has led to the roll-out of the model state-wide, with Professor Sabe Sabesan instrumental in the telehealth governance committee and authorship of the Queensland guidelines for the safe provision of chemotherapy under a remote supervision model.

The Network has also had a national impact, with Professor Sabe Sabesan sitting on the Council of the Clinical Oncology Society of Australia (COSA) and responsible for the development of COSA teleoncology clinical practice guidelines.

Professor Sabesan believes the next step to improve cancer treatment for rural and remote patients is greater access to clinical trials.

To this end, he has played a major role in the design and implementation of the Australasian Teletrial model, developed in collaboration with MTP Connect, the governments of Victoria, New South Wales and Queensland, Medicine Australia and several cancer centres.

This model enhances regional and rural access to clinical trials of new chemotherapy, biotherapy and immunotherapy agents.

Following a successful pilot project, the Australian Government has allocated nearly $125 million for a national roll-out.

“Participation in clinical trials by regional and rural patients is lower than their metropolitan counterparts. If we really want to lift our game and address survival rates and disparity between rural, remote and metropolitan areas, access to clinical trials is key,” said Professor Sabesan.

“Ensuring rural and remote cancer patients have access to the same level of care as their metropolitan counterparts is critical.”

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