Cancer care one call away: Tom McFarlane studies telemedicine in oncology

Monday, May 30, 2016

The average cancer patient will work with over a dozen medical professionals during treatment. Oncologists, pharmacists, nurses, dietitians, and social workers – these are just a few of the many healthcare providers who support cancer patients through their journey.

With nearly 80,000 diagnosed cancer cases as of 2012, the number of appointments and time committed by patients and caregivers is staggering.

Now imagine making appointments with those dozen healthcare providers when you live in a small town in northern Ontario. Would you drive two hours to the nearest regional hospital for a simple follow up appointment? For the almost 15% of Ontarians who live in rural areas, travel time and distance prove serious barriers to accessing healthcare services.

Grand River staff receive a cheuqe for $111,670 from the Telus Ride for Dad foundation. The cheque reads "fighting prostate cancer through research and education".Dr. McFarlane's research with Grand River is one of several Grand River Hospital projects receiving funding. The Telus Ride for Dad program presented McFarlane's partners with a cheque funding all of these projects.

Dr. Tom McFarlane, Clinical Lecturer at the School of Pharmacy, is researching how to overcome those barriers. The plan? Telemedicine – use teleconferencing software to connect Ontario cancer patients in rural areas with pharmacists and nurses. These healthcare providers will conduct the same standard follow-up appointments that are required of in-person patients.

“Pharmacist and nurses can answer questions, suggest changes to medication plans, and provide additional strategies for managing side-effects, all without the patient leaving their home,” explains McFarlane.

Patients tend to prefer oral therapy over IV, if given a choice. With telemedicine, we can ensure that important patient education piece is still occurring.

McFarlane and the research team are examining telemedicine in prostate cancer patients. He’s partnering with oncologists and nurses from Grand River Hospital and with the Ontario Telemedicine Network, a group that uses technology to provide medical expertise at a distance, to run a comparative study. One group of approximately 40 patients will receive telemedicine clinic appointments. Their experiences will be compared against 40 patients receiving traditional, in-person treatment.

Patients will still meet with physicians in person, but after initial treatment plans are determined, follow up appointments and monitoring are conducted via videoconferencing. The study will also include in-person interviews to assess how patients are responding to counselling via phone and video.

Changing cancer landscape makes telemedicine vital

Convenience isn’t the only selling point of telemedicine. As modes of cancer treatment evolve, the need for continuous connection between healthcare providers and patients increases. McFarlane says:

More and more, we’re turning to oral medications to treat cancer. This means that instead of coming in for a regulated and monitored IV treatment session, patients are given a prescription to take home. This puts particular onus on the patient to administer therapy properly.

With the increase in oral chemotherapy treatment use, cancer healthcare providers are noticing a decrease in opportunities for follow-up with patients. Taking medications properly is essential for patients to combat their cancer, and telemedicine could fill a gap here. Remote contact minimizes travel time for all parties involved; patients, both urban and rural, could quickly check-in with healthcare providers who ensure appropriate adherence.

The importance of innovation in oncology

Dr. McFarlane was an oncology pharmacist at Cambridge Memorial Hospital before joining the School of Pharmacy full-time. With his extensive background in cancer treatment, McFarlane recognizes that novel methods of providing care are essential to combatting cancer.

Getting to an appointment is challenging, even if you live in the city. If you’re an elderly man with prostate cancer who lives in a rural area, the challenges are magnified. There are costs incurred: you have to navigate transit and construction, parking and hotels cost money, you might need a caretaker to drive you. It’s vital that we develop strategies to reduce the burden on these patients.

The importance of McFarlane and his team’s work has been acknowledged by many. The telemedicine study has received a $50,000 grant from the Prostate Cancer Fight Foundation’s Ride for Dad program. The project is also funded by Janssen Pharmaceuticals Company and Astellas Pharma.

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