Transcript Hematology and Oncology uses of Telemedicine (Anatomy of

Hematology and Oncology uses
of Telemedicine
(Anatomy of an Outlier)
Jorge J. Nieva M.D.
Billings Clinic Cancer Center
Confessions of a telemedicine doc
TOP 5 telemed users
PRISM research project
Oncology
Neurology
Pulmonary
Dietician
Oncology Visits
794
112
44
41
25
100
80
60
40
20
0
Nieva
BC doc
BC doc
BC doc
BC doc
others
Why use Telemed?
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Research related visits
Discussions on important decisions
requiring family participation
Reducing patient travel costs to
outreach sites
Monitoring labs in hematology patients
Palliative care visits for patients who
have no hospice access
Research Related Visits
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Protocols are
complicated and
inflexible
Outreach visits fall
out of sequence
with research visits
For NCI sponsored
research, telemed is
an adequate
physician office visit.
Serious discussions
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Patients with cancer
are often elderly
Many decisions are
made in conjunction
with family members
Telephone calls
exclude family….and
lead to more
telephone calls.
Patient Travel costs
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Outreach clinic visits
and chemotherapy
are often out of
sequence
Some patients drive
100+ miles to get to
an outreach site.
For patients who just need to
discuss labs…..
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Immune thrombocytopenia
Polycythemia vera
Chronic Myeloid Leukemia
Essential Thrombocytosis
Autoimmune Hemolytic Anemia
Cancer Outreach Clinics
Oncology/Hematology Outreach Clinic Locations
Glacier
Flathead
Kalispell
Toole
Blaine
Havre
Pondera
Phillips
Chouteau
ter
adw
a
Bro
l
til
Dillon
Park
Cody, WY
Yellowstone
Big
TimberColumbus
Livingston
S
t
wa
Billings
er
Carbon
Red Lodge
Glendive, MT
Livingston, MT
Miles City, MT
Carter
Powder
River
Sheridan
Crook
Greybull
Bighorn
Park
Buffalo
Washakie
I-90
Gillette
Worland
Weston
Johnson
Campbell
Thermopolis
Sidney, MT
Fremont
Billings Clinic Oncology
Outreach Clinic Counties
Adams
Big Horn
Hot
Springs
Sheridan, WY
Thermopolis, WY
Williston, ND
Colstrip
Hardin
Lovell
Cody
I-15
Bowman
Sheridan
Powell
Glasgow, MT
Slope
er
Madison
Baker
Stark
Dickinson
g
ttin
He
d
Sweet
Grass
Gallatin
Bozeman
Forsyth
Fallon
Dunn
e
hea
Valley
Custer
Miles City
Wibaux
ur
ver
Roundup
Wheatland Golden
I-94
Rosebud
Musselshell
Meagher
Glendive
Prairie
eas
Bea
Petroleum
Lewistown
Tr
Deer
Lodge Silver Butte
Bow
Ravalli
Outreach Clinic Locations
Jefferson
Garfield
McKenzie
y
Golden Valle
Judith
Basin
ell
Granite
Dawson
Fergus
Great Falls
w
Po
al
er
in
M
Missoula
Missoula
Williston
Richland
Sidney
Billings
Cascade
Williams
Wolf Point
McCone
Sanders
Lewis &
Clark
Sheridan
Roosevelt
Valley
Glasgow
HWY 2
Teton
Lake
Divide
Daniels
Scobey
Hill
Libe
rty
Lincoln
Natrona
Riverton
Casper
I-25
Other Service Area Counties
Jan. 31, 2006
Thank You !