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Quality care close to home - Tele-oncology in Eastern NS
"Distance is not a Barrier"

The Cape Breton Cancer Care Tele-oncology Project is getting rave reviews from both rural cancer patients and cancer health professionals. Chris Hillier, Medical Dosimetrist and Cape Breton Cancer Centre Project lead credits its early success to “having the right people at the right table” all working toward the common goal of improving cancer care for rural patients in Eastern Nova Scotia.

The Cape Breton Cancer Centre serves patients in the eastern end of province as far as Antigonish. About 40 per cent live in rural areas and until recently, all patients had to travel up to three hours for medical appointments rela2015teleheatlhted to cancer treatment.
Today, thanks to the Cape Breton Cancer Care Tele-oncology Project, many rural patients, who live more than one hour from Sydney, are provided with the option of having their appointments with cancer specialists closer to where they live through tele-oncology – high tech video conferencing.

Three factors are involved in determining if a patient will have their appointment through the tele-oncology program: the patient’s address, the specialist’s pre-assessment of the patient’s clinical needs and patient preference. All rural patients who meet location and clinical requirements are offered the option of having consultations and follow-up appointments with specialists through tele-oncology or to visit the Cape Breton Cancer Centre in person.

“Tele-oncology is really an extension of the examination room at the cancer centre,” said Mr. Hillier. “The high definition cameras create a high quality real visual experience for both the patient and the specialist. The technology enables the physician to share x-rays, CT scans and other test results with patients exactly the same as if both patient and physician were in the same room.”

Currently, patients who choose to use tele-oncology travel to one of two sites, St. Martha’s Hospital in Antigonish or Inverness Consolidated Hospital. However, it is likely that the number of locations will expand in future to include Cheticamp, Strait Richmond and Neil’s Harbor.

The tele-oncology appointment is very similar to the in-person appointment. The patient goes to the tele-oncology hospital closest to where they live and registers. An on-site oncology nurse completes an assessment, and shares it with the oncologist via tele-oncology. The patient is then brought into the tele-oncology room and meets with the oncologist. The nurse or a physician at the local hospital is present throughout the appointment similar to an in-person appointment.

“Oncologists and nurses are very content with the program, and they are seeing patients sooner,” said Mr. Hillier. “Patients are more than happy, physicians want to use it and both of these aspects are key to the program`s success.”

Dr Waseem Sharieff, a Radiation Oncologist at the Cape Breton Cancer Centre, has been using the Tele-Oncology program for his patients over the last year.

“Tele-oncology gives me the ability to reach my patients in a more efficient timely manner,” said Dr. Sharieff. “The program allows me to adequately work-up my patients before they visit the cancer center for their first appointment, and patients are more likely to attend their follow-up appointments through tele-oncology if we remove the burden of travel.”

Mr Hillier indicated that the high degree of satisfaction with the program may be due to a decision to implement what is known as a ‘small test of change’ suggested by Jill Petrella, Quality Manager with Cancer Care Nova Scotia.

This meant that every couple of weeks the project team reviewed what went well with the scheduled appointments and what went wrong and made regular changes and adjustments to improve the project and address any challenges as they occurred.

“This project has really become the ‘poster child’ for continuous quality improvement,” said Ms. Petrella. “The next step involves surveying patients and providers to formally evaluate the project to date.”

The hope is that, in time, the project will expand further into other aspects of cancer care such hematology, supportive care and nutrition.

In the meantime the Cape Breton Cancer Care Tele-oncology project team are pleased that they are helping to ease the burden of cancer care for rural patients in Eastern Nova Scotia and hope that others may be able to learn from and build on their experience.

The Cape Breton Cancer Care Tele-oncology Project is guided by the Tele-oncology working group, which includes representatives from the Cape Breton Cancer Centre, Inverness Consolidated Hospital, St. Martha’s Regional Hospital, Yarmouth Regional Hospital, Nova Scotia Cancer Centre, Cancer Care Nova Scotia, Nova Scotia Health Authority (IM/IT), Nova Scotia TeleHealth Network and the Cape Breton Regional Hospital Foundation.

In September 2014, the Cape Breton Hospital Foundation through the generous support of Jeannie, Chris, and Hannah Fraser (Genesis Communication) purchased the required equipment and funded the necessary room renovations to make the project possible. .



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