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November 27 th , 2018| 4 pm Telemedicine in Hematology &Oncology Care Sarvari Yellapragada, MD

November 27 th , 2018| 4 pm Telemedicine in Hematology &Oncology Care Sarvari Yellapragada, MD Michael E DeBakey VA Medical Center Dan L Duncan Cancer Center, Baylor College of Medicine. Role of Telemedicine at the Michael E DeBakey Medical Center (MEDVAMC).

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November 27 th , 2018| 4 pm Telemedicine in Hematology &Oncology Care Sarvari Yellapragada, MD

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  1. November 27th, 2018| 4 pm Telemedicine in Hematology &Oncology Care Sarvari Yellapragada, MD Michael E DeBakey VA Medical Center Dan L Duncan Cancer Center, Baylor College of Medicine

  2. Role of Telemedicine at the Michael E DeBakey Medical Center (MEDVAMC) • The MEDVAMC has pioneered telemedicine in various disciplines • Practical applications of telemedicine in hematology & oncology • Tele-consultation and multidisciplinary care • Tele-medicine for patient centered care

  3. SESSION LEARNING OBJECTIVES • Variety of applications of telemedicine for blood & cancer disorders • Telemedicine for specialty care: interface with consultants • Telemedicine to improve access for Veterans (patients) & care-givers

  4. MedvamcMULTIDISCIPLINARY Virtual TUMOR BOARD CONFERENCES

  5. Oncologic Expertise Offered at MEDVAMC • Medical Specialties • Medical Oncology • Hematology Oncology • Genetics • Pulmonary • Palliative Care • Gastroenterology • Hepatology • Women’s Health Center • Surgical Specialties • Surgical Oncology • Breast Surgical Oncology • Hepatobiliary Surgery • Transplant Surgery • Cardiothoracic Surgery • Head & Neck Surgery • Diagnostic Specialties • Radiology • Nuclear Medicine • Breast radiology • Interventional Radiology • Radiation Oncology • Pathology

  6. Unique MEDVAMC Oncology Services • Genetics • One of 3 programs nationally • Transplant Hepatology • One of 6 hepatology transplant programs nationally • Palliative Care • One of 2 programs nationally • Radiation Oncology • MEDVAMC is the only one offering Cyberknife radiation program nationally • Interventional Radiology • One of few interventional radiology programs nationally • Breast Radiology • One of the largest breast imaging programs nationally • Consulting other VHA facilities for the breast imaging programs • Consulting other VHA facilities for mammogram checklist nationally • Women’s Health Center • One of the largest Women’s Health Center program nationally

  7. What is MEDVAMC Virtual Tumor Board (VTB) • Multi-institutional collaborative developed in 2010 • Goal to improve access, timeliness, and quality of cancer care • Telemedicine technology and teleconsultation to link providers at two different Veterans Affairs (VA) facilities • Videoconference equipment • Electronic Medical Records • MEDVAMC Cancer Program is one of the largest VA Medical Centers in the nation • Primary referral institution for complex cancer care within VISN16 • National referral center for select services

  8. Development of VTB • Timeline • Tumor Board Conference Offered • General • Hepatocellular Carcinoma (HCC) • Head & Neck • Pulmonary • Genitourinary

  9. Multidisciplinary VTB Conferences

  10. MEDVAMC VTB coverage

  11. How MEDVAMC VTB Works Repeat as necessary

  12. MEDVAMC VTB Referral Flowchart:

  13. How V-TB is presented • Referral facility video-conferenced to screen • Presenter gives relevant oncologic history Discussion with the multidisciplinary subspecialty Houston team and referring facility for the final treatment plan. Multidisciplinary VTB Houston Team Leaders: Sarvari Yellapragada, MD, Hematologist/Oncologist; Alka Mulchandani, CTR, Lead Cancer Registrar, Anita Sabichi, MD, Acting Chief Hematology/Oncology Section and Nader Massarweh, MD, Surgical Oncology

  14. Benefits of VTB • Efficiency in diagnosis and treatment planning • Increased timeliness in creating and initiating care plan • Decreased system-level costs • Reduction of unnecessary diagnostic studies • Decrease in costs associated with patient travel and lodging • Increased patient-centric care • Decrease in travel burden on patients/families • For patients who do travel to Houston • Increased efficiency in scheduling appointments and diagnostic studies • Better coordination of multidisciplinary care • Increase networking and communications between VHA facilities

  15. Telemedicine clinics

  16. Telemedicine Clinic Model

  17. Increasing access to Teleclinics

  18. Patient satisfaction survey

  19. Outcomes of Telemedicine

  20. Conclusion Advantages Barriers Limitations in physical exam and emergency services Appropriate selection Provider engagement Technological limitations Contingency plans if natural disasters • Tele consultation modality • Improve individual patient access • Reduce travel costs • Improve caregiver engagement • Palliative care

  21. Thank you to all Veterans, the MEDVAMC and Cancer Center team

  22. QUESTIONS?THANK YOU

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