title: Telehealth--a change in a practice model in oncology.
abstract: BACKGROUND
  A clinical study to examine the barriers to using telehealth for oncologic visits was performed by the British Columbia Cancer Agency's Vancouver Island Centre (BCCAVIC) and the Vancouver Island Health Authority in 2006-2007. One of the major barriers encountered was physician engagement. The current observational study was to determine whether patients' enthusiasm and the introduction of telehealth in a study resulted in telehealth becoming integrated within BCCAVIC.
  
  
  METHODS
  Telehealth appointment statistics continued to be kept after the original study was completed. Data were kept on the number of visits, the type of visit (follow-up or new patient), the oncologist seeing the patient, the location of the patient, and the type of cancer.
  
  
  RESULTS
  During the study, 106 patients were seen via telehealth. In the years following the trial, the number of telehealth follow-up patients seen markedly increased, so that in 2010-2011, close to 1,200 patients were seen. Medical oncology saw 91.4% of these.
  
  
  CONCLUSIONS
  The introduction of oncology telehealth in BCCSVIC/Vancouver Island Health Authority was in an ethics-approved study. Following the completion of the trial, there was a 10-fold increase in follow-up patients seen using this modality. Reluctance to see new patients through telehealth probably relates to the necessity to change the patient encounter paradigm. There is a need to develop a model where patients who are a distance from specialists concentrated in larger centers have reasonable access to the same standard of care, without incurring the time and financial burdens. Telehealth would be a part of that model.
authors.affiliation: Administration, Vancouver Island Health Authority, Victoria General Hospital, Victoria, British Columbia, Canada. brian.weinerman@viha.ca
authors.forename: Brian Harvey
authors.initials: BH
authors.lastname: Weinerman
authors.forename: Jeff
authors.initials: J
authors.lastname: Barnett
authors.forename: Margarita
authors.initials: M
authors.lastname: Loyola
authors.forename: Johanna
authors.initials: J
authors.lastname: den Duyf
authors.forename: Sarah
authors.initials: S
authors.lastname: Robertson
authors.forename: Valerie
authors.initials: V
authors.lastname: Ashworth
authors.forename: Lars
authors.initials: L
authors.lastname: Apland
authors.forename: Arminee
authors.initials: A
authors.lastname: Kazanjian
mesh_terms: D001955:British Columbia; D006801:Humans; D008495:Medical Oncology / Q000458:organization & administration* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D017216:Telemedicine / Q000458:organization & administration* / Q000706:statistics & numerical data