title: Telemedicine in radiotherapy: a study exploring remote treatment planning, supervision and economics.
abstract: In January 2002, the departments of radiotherapy at the University Hospital of North Norway and the Norwegian Radium Hospital were connected through a 2 Mbit/s digital telecommunication line. The treatment planning systems at the two institutions were connected and videoconferencing units were installed. We explored the feasibility of remote treatment planning, supervision, second opinions and education. Tests involved two dummy cases and six patients. Remote simulation procedures were carried out for five patients. A cost-minimization analysis was performed. Treatment planning was not completely successful as the software could not handle plans including bolus or weighting between the fields. Remote supervision was possible. A common patient record and radiotherapy system, including digital imaging, digital prescription and approval forms and digital signature, were felt to be desirable. The threshold (break-even point) comparing the costs of telemedicine with those of transportation by air was 12 patients/year. Telemedicine in radiotherapy appears to be feasible, but some limitations must be overcome.
authors.affiliation: Department of Oncology, University Hospital of North Norway (UNN), Tromsø, Norway. jan.norum@unn.no
authors.forename: Jan
authors.initials: J
authors.lastname: Norum
authors.forename: Øyvind S
authors.initials: ØS
authors.lastname: Bruland
authors.forename: Oddvar
authors.initials: O
authors.lastname: Spanne
authors.forename: Trine
authors.initials: T
authors.lastname: Bergmo
authors.forename: Tor
authors.initials: T
authors.lastname: Green
authors.forename: Dag R
authors.initials: DR
authors.lastname: Olsen
authors.forename: Jan H
authors.initials: JH
authors.lastname: Olsen
authors.forename: Elisabeth E
authors.initials: EE
authors.lastname: Sjåeng
authors.forename: Tatiana
authors.initials: T
authors.lastname: Burkow
mesh_terms: D000293:Adolescent; D000328:Adult; D003365:Costs and Cost Analysis / Q000379:methods; D004502:Education, Medical, Continuing; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000191:economics / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted / Q000191:economics / Q000379:methods*; D019114:Remote Consultation / Q000191:economics / Q000379:methods; D017216:Telemedicine / Q000191:economics / Q000379:methods*; D049269:Videoconferencing / Q000295:instrumentation