Native People for Cancer Control Telehealth Network

1. Native People for Cancer Control Telehealth Network Roy Colven Cara Towle Lisa R Thomas HollyAnna Pinkham March 12, 2007

2. Native People for Cancer Control Telehealth Network (NPCCTN): Overall Goal • To reduce the gap between American Indians/Alaska Natives and other groups in cancer care • To improve the results of cancer treatment in American Indians and Alaska Natives • To support Native cancer survivors, their health care providers, and their families

3. NPCCTN Funding • Office for the Advancement of Telehealth (Health Resources and Services Administration) • $250,000 per year x 3 years

4. NPCCTN Partners • South Puget Sound Intertribal Planning Agency • Alaska Native Tribal Health Consortium • Individual Tribes and their communities • University of Washington • Seattle Cancer Care Alliance • University of Washington Medicine • Children’s Hospital and Regional Medical Center • Fred Hutchinson Cancer Research Center

5. NPCCTN Collaborations • Tribal Councils • Tribal organizations • Tribal Health Care Clinics • Urban Indian Health Care Facilities, e.g., Alaska Native Medical Center, Alaska Federal Health Care Access Network, Seattle Indian Health Board • Cancer treatment facilities • NCI-funded Cancer Information Service • Washington State Comprehensive Cancer Control Steering Committee

6. Telemedicine • The use of electronic information and communications technologies to provide and support health care when distance separates the participants.” IOM 1996

7. Telehealth Telehealth encompasses a broader definition of remote healthcare that does not always involve clinical services. • Videoconferencing • Transmission of still images • E-health including patient portals • Remote monitoring of vital signs • Continuing medical education • Nursing call centers • … are all considered part of telemedicine and telehealth. American Telemedicine Association http://www.americantelemed.org/

8. NPCCTN Activities • Utilize telehealth technologies to provide education and consultative services and support to cancer patients and their providers: • Comprehensive Care Plans • Pain related to cancer • Psychological issues related to cancer, including support group creation • Legal issues related to cancer diagnosis and end-of life issues • End of life care and planning

9. NPCCTN Activities • Facilitating virtual tumor board participation • Supporting patient referrals and returns coordination • Sharing educational resources between academic, clinical care, and tribal partners, such as continuing education and training • Continuous evaluation of services to determine value, satisfaction and impact

10. NPCCTN Staff • Dedra Buchwald, MD, Principle Investigator • Roy Colven, MD, Co-Investigator/Project Director • Cara Towle, RN, Project Manager and Technical Liaison • HollyAnna Pinkham (Yakama), Community Outreach Specialist for Washington • Lisa R Thomas, PhD (Tlingit), Research Scientist and Community Outreach Specialist for Alaska • Rande Gray, Technical Specialist Deborah Friedman, MD, Consultant in Care of Cancer Survivors • Fransing Daisy, PhD (Cree), Mental Health Consultant • Ron Whitener, JD PhD (Squaxin Island), Legal Consultant • Anajana Kundu, MD, Pain Consultant • Ardith Doorenbos, PhD RN, End of Life Consultant • George Guilmet, PhD, Program Evaluation

11. NPCCTN in Washington • Prospective participants: SPIPA tribes + Quinault • Next steps: • Meet with individual tribes • Understand needs at each partner site • Determine which NPCCTN services may benefit each partner site • Determine technical needs • Tribal resolution at each partner site • Collaboratively establish NPCCTN service protocols

12. NPCCTN in Washington: Technical Plans • K-20 Educational Telecommunications Network • 48 Public Baccalaureate sites • 71 Community/Technical Colleges • 307 K-12 sites • 65 Library sites (proposed) • 15 Private Baccalaureate sites (proposed)

14. NPCCTN in Washington: Technical Plans • Benefits of K-20 Network membership • Provides significant bandwidth for a fraction of commercial costs for all rural sites. • Allows access to K-20 bridge for multi-point conferences. • Provides toll-free calling within network or to Seattle area. • Open network allows out of system calls. • Result: Increased sustainability beyond grant funding.

15. Alaska NPCCTN updates

16. Alaska Partners • CANCER IS THE LEADING CAUSE OF DEATH FOR ALASKA NATIVES • 229 federally recognized Tribes • 16% of the population • 60% live in small remote communities generally without connection to a road system • Needs and resource assessment

18. Meeting with our Alaska partners • January 2007 • Alaska Native Tribal Health Consortium • Alaska Native Health Research • Alaska Native Medical Center • Alaska Federal Health Care Access Network • American Cancer Society, Alaska

19. Alaska Native Health Care • Alaska Tribal Health System • Village-based clinics • Regional hospitals • Sub-regional clinics • Alaska Native Medical Center • Contract care (Seattle) • ANTHC is the largest Tribal self-governance entity in the US • Telehealth is recognized as an essential component to health care in Alaska

21. NPCCTN and Alaska – service providers • Virtual tumor boards • CME for service providers • Training for community health aides • Coordinate transfer of cancer patients between Alaska and Seattle • Follow-up care for patients in the bush • Survivorship care • Palliative care • Support groups

22. Next steps • Meet with Community Health Aids • Meet with regional and sub-regional clinics • Meet with village clinics • Meet with Alaska Native cancer patients and their families

23. Gunalchéesh