3 research outputs found
Training the Trainees in Radiation Oncology with Telemedicine as a Tool in a Developing Country: A Two-Year Audit
Purpose. The estimated new cancer patient load in the Indian state of Uttar Pradesh is 0.1â0.12 million per year. Approximately two thirds of these require treatment by a radiation oncologist. Radiation oncologists: cancer patient ratio in this state is 1â:â2000 as compared to the recommended 1â:â250. This problem is compounded by the poor infrastructure of radiation oncology departments in the state which is suboptimal for teaching, training of resident doctors, and treatment in most barring a few departments. To bridge some gap in the sociodemographics stated above and enhancement of training of residents, we submitted a project for establishment of a telemedicine facility in our department to the Department of Science and Technology, Government of India. We present the design, implementation, and a two-year audit of our tele-education activities. Materials and Methods. After the sanction of the project, we established telemedicine linkage with another medical institute in the city located 25âkms away in 2007. After implementation of the project, academic sessions designed for trainee residents in our department were shared with the remote end. A record of these activities and a feedback of the activities were audited at the end of 2 years of implementation of this project. Results. Regular videoconferencing sessions comprising of lectures on clinical oncology, medical physics, and radiobiology were held. Feedback from the users revealed satisfaction with the content of the academic sessions for the purpose of MD training. Conclusions. Distance education in radiation oncology is an important tool for training of the trainee residents
La tĂ©lĂ©mĂ©decine en radiothĂ©rapie : dĂ©veloppement dâun modĂšle et analyse des coĂ»ts
But : La radiothĂ©rapie (RT) est disponible seulement dans les grandes villes au QuĂ©bec. Les patients atteints de cancer vivant en zone rurale doivent voyager pour obtenir ces soins. Toute proportion gardĂ©e, moins de ces patients accĂšdent Ă la RT. LâaccessibilitĂ© serait amĂ©liorĂ©e en instaurant de petits centres de RT qui dĂ©pendraient de la tĂ©lĂ©mĂ©decine (tĂ©lĂ©RT). Cette Ă©tude tente (1) de dĂ©crire un modĂšle (population visĂ©e et technologie) rĂ©aliste de tĂ©lĂ©RT; (2) dâen estimer les coĂ»ts, comparativement Ă la situation actuelle oĂč les patients voyagent (itineRT).
MĂ©thode : (1) Ă lâaide de donnĂ©es probantes, le modĂšle de tĂ©lĂ©RT a Ă©tĂ© dĂ©veloppĂ© selon des critĂšres de : faisabilitĂ©, sĂ©curitĂ©, absence de transfert des patients et minimisation du personnel. (2) Les coĂ»ts ont Ă©tĂ© estimĂ©s du point de vue du payeur unique en utilisant une mĂ©thode publiĂ©e qui tient compte des coĂ»ts en capitaux, de la main dâoeuvre et des frais gĂ©nĂ©raux.
RĂ©sultats : (1) Le modĂšle de tĂ©lĂ©RT proposĂ© se limiterait aux traitements palliatifs Ă 250 patients par annĂ©e. (2) Les coĂ»ts sont de 5918) pour tĂ©lĂ©RT comparativement Ă 4541) pour itineRT. Les coĂ»ts annuels de tĂ©lĂ©RT sont de 1,48 M), avec une augmentation des coĂ»ts nets de seulement 0,54 M) comparativement Ă itineRT. Si on modifiait certaines conditions, le service de tĂ©lĂ©RT pourrait sâĂ©tendre au traitement curatif du cancer de prostate et du sein, Ă coĂ»ts similaires Ă itineRT.
Conclusion : Ce modĂšle de tĂ©lĂ©RT pourrait amĂ©liorer lâaccessibilitĂ© et lâĂ©quitĂ© aux soins, Ă des coĂ»ts modestes.Purpose: Radiotherapy (RT) is centralized in urban areas in Quebec. Patients with cancer living in remote areas must travel to receive RT, and the proportion of RT patients is inferior to that of urban patients. Telemedicine could allow a minimally staffed RT unit to operate at reasonable costs in a rural setting. This study aims (1) to outline a feasible structure and target population for a tele-radiotherapy unit (teleRT); and (2) to estimate the costs of teleRT, compared to the current situation based on travel to urban centres (travelRT).
Methods and Materials: (1) We developed an evidence-based teleRT model meeting the criteria of: feasibility & safety, elimination of patient travel, and minimisation of staff migration. (2) Costs were estimated from the public payor perspective using a previously published activity-based costing model for RT. The model included annualized capital costs, labour, and overhead.
Results: (1) In our model, teleRT was restricted to 250 palliative care patients per year. (2) The public payor cost of teleRT was 5918) as compared to 4541) for travelRT. Yearly costs of the teleRT unit was 1,48 M), with a net cost increase to the payor of 0,54 M) compared to travelRT. Under less stringent conditions, breast and prostate cancer patients could also benefit from teleRT at similar costs to travelRT.
Conclusion: Establishing a teleRT unit to treat a small rural population of palliative care patients results in a modest net increase in cost to the public payor and could lead to increased accessibility and equity