Telemedicine session

Telemedicine session at UMGCCC

With the help of a new University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC) telemedicine program, patients receiving cancer treatment at affiliated community hospitals now have access to the same clinical trials and novel treatments that are currently available at major academic cancer centers, such as UMGCCC. Patients can remain in their communities, but still receive the benefits of UMGCCC expertise.

"The great benefit for patients is that they can get access to the cutting edge clinical trial opportunities and novel therapies that historically have only existed at major academic institutions. Now they can get that care in their own backyards," said William Regine, M.D., chairman of UMGCCC's Department of Radiation Oncology. Dr. Regine is also a professor of radiation oncology at the University of Maryland School of Medicine.

Telemedicine, where physicians at different physical locations communicate with each other in real time through video and telephone connections, allows physicians at UMGCCC's Department of Radiation Oncology in downtown Baltimore to consult and review cases with physicians in affiliated radiation oncology community practices in Anne Arundel and Howard Counties and together decide the best treatment plan for patients and monitor patients' progress. Patients treated at affiliated community radiation oncology centers have increased opportunities to benefit from all that UMGCCC has to offer.

Telemedicine is achieved using video cameras, television monitors and audio connections to the other institutions through dedicated, high-speed telephone lines. Doctors in Baltimore and the affiliated practices can evaluate patient's films, their X-rays and other materials together at the same time.

"If they have a video image of the patient they want to show us, we can literally see it here in Baltimore and discuss it live with our colleagues in their community locations," said Mohan Suntha, M.D., University of Maryland Medical System President and CEO. Dr. Suntha is also a professor of radiation oncology at the University of Maryland School of Medicine and associate director of the Greenebaum Comprehensive Cancer Center.

Doctors at the community practices can present cases to UMGCCC physicians and UMGCCC physicians can present cases to community physicians. The program allows physicians in all practice areas to remain current on new therapies and approaches to treatment.

Should a patient need to come to UMGCCC for treatment, physicians in Baltimore will already be familiar with that patient's needs and will maintain ongoing communication with referring physicians, returning patients to their local physicians for follow-up care as soon as possible.

"Because this approach increases awareness and communication, we are convinced that means better treatment options and patient care for patients downtown and in the community," said Dr. Suntha. "In addition, telemedicine increases the information that's passed from physician to physician about opportunities for patients to enroll in clinical trials. Clinical trials give our patients the option to consider new techniques that will not be commercially available for up to five years. That's a huge step forward."

In the last several years, UMGCCC has set up radiation oncology community practices at Central Maryland Radiation Oncology in Howard County, and at Baltimore Washington Medical Center's Tate Cancer Center.

The medical directors at these centers are faculty members at the University of Maryland School of Medicine and many of the faculty and staff are University employees.

The practices were set up with a high level of technology, often only found at large academic cancer centers. But as Dr. Suntha noted, one of the challenges with high technology centers is how to keep all the centers talking to each other.

"When a patient walks in the door at CMRO or at Baltimore Washington Medical Center, we are committed to ensuring that patients get the same access to clinical trials that they would if they came to UMGCCC in Baltimore. UMGCCC's telemedicine program provides the solution," he noted.

"What telemedicine has clearly allowed us to do is to integrate those community programs under the umbrella of UMGCCC and our overall cancer vision to provide the best cancer care for Marylanders," Dr. Suntha said.

Program Funding

The telemedicine program is funded through the Maryland Cigarette Restitution Fund Program (CRFP). Within the CRFP, a portion of those funds went to the Maryland Statewide Health Network (MSHN), developed and operated by the University of Maryland School of Medicine. MSHN provided support for establishing the telemedicine program at UMGCCC to set up a teleconferencing network so that patients in selected regions of the state could have access to the expertise, clinical trials and novel therapies that have previously only been available in Baltimore. Working with MSHN, UMGCCC would like to extend this program to other regions of the state.

Benefit to Patients and Doctors

Dr. Suntha cites the University of Maryland Medical Center's Gamma Knife Center as a great example of how patients can benefit from this program. "Since our morning conference in Baltimore now includes the participation of our affiliated practices through the telemedicine link, we now hear about patients who are seen in the community. We can make recommendations about Gamma Knife therapy, which is a highly specialized treatment for brain tumors. Those patients can come to UMGCCC and be evaluated for that therapy. It is access to technology like this that telemedicine allows us to emphasize."

In fact, he says the very first day the program got started, there was a patient from one of the community practices who had a brain tumor.

"The recommendation of using Gamma Knife technology on that patient and combining it with external beam radiation in the community probably tripled that patient's chance of being cured," stated Dr. Suntha. "So the patient received Gamma Knife here at UMGCCC and went back to our affiliated community practice to receive his radiation therapy."

The Future of Telemedicine

"Telemedicine is in its infancy here at UMGCCC, but we intend to expand beyond just radiation oncology to really have multidisciplinary clinics and conferences so that the community physician can actually access expertise from a number of specialists all at once," said Dr. Suntha.

At these multidisciplinary conferences, experts in surgery, medical oncology and radiation oncology would meet together to discuss specific diseases (for example, lung cancer) and teleconference to other locations so that community-based physicians could access the expertise of all the UMGCCC specialists at the same time.

The missing link to realizing the benefits of the academic environment in non-academic settings was real-time connectivity. This connectivity now exists among colleagues associated with UMGCCC throughout the region. "It's really the future of where we want to take multidisciplinary care. Right now it works in its infancy around radiation oncology. Our vision is to expand it across the cancer center through all the specialties and remove all of the barriers to the academic village," said Dr. Suntha.