title: Consultation via telemedicine and access to operative care for patients with head and neck cancer in a Veterans Health Administration population.
abstract: The purpose of this study was to evaluate a telemedicine model that utilizes an audiovisual teleconference as a preoperative visit.
  
  
  
  Veterans Health Administration (VHA) patients with head and neck cancer at 2 remote locations were provided access to the Palo Alto Veterans Affairs (PAVA) Health Care System otolaryngology department via the telemedicine protocol: tissue diagnosis and imaging at the patient site; data review at PAVA; and a preoperative teleconference connecting the patient to PAVA. Operative care occurred at PAVA. Follow-up care was provided remotely via teleconference.
  
  
  
  Fifteen patients were evaluated. Eleven underwent surgery, 4 with high-grade neoplasms (carcinoma). Average time from referral to operation was 28 days (range, 17-36 days) and 72 (range, 31-108 days), respectively, for high-grade and low-grade groups. The average patient was spared 28 hours traveling time and $900/patient was saved on travel-related costs.
  
  
  
  A telemedicine model enables timely access to surgical care and permits considerable savings among select VHA patients with head and neck cancer. © 2016 Wiley Periodicals, Inc. Head Neck 38: 925-929, 2016.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Palo Alto Veterans Affairs Health Care System, Palo Alto, California.|Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Beswick
authors.affiliation: Center for Innovation to Implementation, Palo Alto Veterans Affairs Health Care System, Palo Alto, California.
authors.forename: Anita
authors.initials: A
authors.lastname: Vashi
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Palo Alto Veterans Affairs Health Care System, Palo Alto, California.|Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Yohan
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Pham
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: F Chris
authors.initials: FC
authors.lastname: Holsinger
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico.
authors.forename: James D
authors.initials: JD
authors.lastname: Rayl
authors.affiliation: Ambulatory Care Service, Palo Alto Veterans Affairs Health Care System, Palo Alto, California.
authors.forename: Beth
authors.initials: B
authors.lastname: Walker
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, California.
authors.forename: John
authors.initials: J
authors.lastname: Chardos
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Palo Alto Veterans Affairs Health Care System, Palo Alto, California.
authors.forename: Annie
authors.initials: A
authors.lastname: Yuan
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Palo Alto Veterans Affairs Health Care System, Palo Alto, California.
authors.forename: Ella
authors.initials: E
authors.lastname: Benadam-Lenrow
authors.affiliation: Department of Surgery, Central California Veterans Affairs Health Care System, Fresno, California.
authors.forename: Dolores
authors.initials: D
authors.lastname: Davis
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Palo Alto Veterans Affairs Health Care System, Palo Alto, California.|Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: C Kwang
authors.initials: CK
authors.lastname: Sung
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Palo Alto Veterans Affairs Health Care System, Palo Alto, California.|Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Vasu
authors.initials: V
authors.lastname: Divi
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Palo Alto Veterans Affairs Health Care System, Palo Alto, California.|Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Davud B
authors.initials: DB
authors.lastname: Sirjani
mesh_terms: D017046:Cost Savings; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D012017:Referral and Consultation; D013685:Telecommunications; D017216:Telemedicine / Q000191:economics; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans; D014850:Waiting Lists
keywords: Veterans Affairs; Veterans Health Administration; access; cancer; head and neck; telehealth; telemedicine