title: Timely access to specialist medical oncology services closer to home for rural patients: experience from the Townsville Teleoncology Model.
abstract: OBJECTIVE
  Prior to 2009, the teleoncology model of the Townsville Cancer Centre (TCC) did not achieve its aims of equal waiting times for rural and urban patients and the provision of reliable, local acute cancer care. From 2007-2009, 60 new patients from Mt Isa travelled to TCC for their first consultation and their first dose of chemotherapy. Six of these patients required inter-hospital transfers and eight required urgent flights to attend outpatient clinics. Only 50% these rural patients (n = 30) were reviewed within one week of their referral, compared with 90% of Townsville patients.
  
  
  METHODS
  A descriptive study.
  
  
  METHODS
  TCC provides teleoncology services to 21 rural towns; the largest is Mt Isa, Qld.
  
  
  METHODS
  Specialist review of 90% of urgent cases within 24 hours, and 90% of non-urgent cases within one week of referral via videoconferencing. A 50% reduction in inpatient inter-hospital transfers from Mt Isa to Townsville.
  
  
  METHODS
  Employment of a half-time medical officer and a half-time cancer care coordinator, and implementation of new policies.
  
  
  RESULTS
  Between 2009 and 2011, TCC provided cancer care to 70 new patients from Mt Isa. Of these new patients, 93% (65/70) were seen within one week of referral. All 17 patients requiring urgent reviews were seen within 24 hours of referral and managed locally thus eliminating the need for inpatient inter-hospital transfers.
  
  
  CONCLUSIONS
  Provision of timely acute cancer care closer to home requires an increase in the rural case complexity and human resources.
authors.affiliation: Department of Medical Oncology, Townsville Cancer Centre, Townsville, Queensland, Australia; School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
authors.forename: Sabe
authors.initials: S
authors.lastname: Sabesan
authors.forename: Lynden J
authors.initials: LJ
authors.lastname: Roberts
authors.forename: Peter
authors.initials: P
authors.lastname: Aiken
authors.forename: Abhishek
authors.initials: A
authors.lastname: Joshi
authors.forename: Sarah
authors.initials: S
authors.lastname: Larkins
mesh_terms: D006297:Health Services Accessibility; D006801:Humans; D008495:Medical Oncology / Q000379:methods* / Q000458:organization & administration; D017146:Models, Organizational; D009936:Organizational Innovation; D058996:Quality Improvement / Q000458:organization & administration; D011793:Queensland; D019035:Rural Health Services / Q000458:organization & administration; D012424:Rural Population; D017216:Telemedicine / Q000379:methods* / Q000458:organization & administration
keywords: health service models; new models and frameworks; rural; telehealth; telemedicine