title: The development of a telemedical cancer center within the Veterans Affairs Health Care System: a report of preliminary clinical results.
abstract: In order to optimize the delivery of multidisciplinary cancer care to veterans, our institution has developed a regional cancer center with a telemedical outreach program. The objectives of this report are to describe the organization and function of the telemedical cancer center and to report our early clinical results. The Veterans Affairs Health Care System is organized into a series of integrated service networks that serve veterans within different areas throughout the United States. Within Veterans Integrated Service Network 20 (Washington, Alaska, Idaho, Oregon) we have developed a regional cancer center with telemedicine links to four outlying facilities within the service area. The telemedical outreach effort functions through the use of a multidisciplinary telemedicine tumor board. The tumor board serves patients in outlying facilities by providing comprehensive, multidisciplinary consultation for the complete range of malignancies. For individuals who do require referral to the cancer center, the tumor board serves to coordinate the logistical and clinical details of the referral process. This program has been in existence for 1 year. During that time 85 patients have been evaluated in the telemedicine tumor board. Sixty-two percent of the patients were treated at their closest facility; 38% were referred to the cancer center for treatment and/or additional diagnostic studies. The patients' diagnoses included the entire clinical spectrum of malignant disease. Preliminary clinical results demonstrate the program is feasible and it improves access to multidisciplinary cancer care. Potential benefits include improved referral coordination and minimization of patient travel and treatment delays.
authors.affiliation: Department of Surgery, VA Puget Sound Health Care System and the University of Washington Seattle, Washington 98108, USA. kevinb@u.washington.edu
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Billingsley
authors.forename: David L
authors.initials: DL
authors.lastname: Schwartz
authors.forename: Susan
authors.initials: S
authors.lastname: Lentz
authors.forename: Eric
authors.initials: E
authors.lastname: Vallières
authors.forename: R Bruce
authors.initials: RB
authors.lastname: Montgomery
authors.forename: William
authors.initials: W
authors.lastname: Schubach
authors.forename: David
authors.initials: D
authors.lastname: Penson
authors.forename: Bevan
authors.initials: B
authors.lastname: Yueh
authors.forename: Howard
authors.initials: H
authors.lastname: Chansky
authors.forename: Claudia
authors.initials: C
authors.lastname: Zink
authors.forename: Darla
authors.initials: D
authors.lastname: Parayno
authors.forename: Gordon
authors.initials: G
authors.lastname: Starkebaum
mesh_terms: D000368:Aged; D002173:Cancer Care Facilities / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009936:Organizational Innovation; D017216:Telemedicine / Q000458:organization & administration* / Q000639:trends; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration* / Q000706:statistics & numerical data