Teleoncology model of care, current and

future state of telemedicine in managing

cancer care.
Abstract: Telemedicine is the use of
telecommunication in order to offer
healthcare mainly aimed at eliminating the
access and distance barriers and make
healthcare readily accessible to the rural
population. One such branch of the
telemedicine is the tele oncology that deals
with managing cancer in the rural areas
where healthcare accessibility remains a
major concern. This paper brings about how
teleoncology is much more than avoiding to
travel long distances for treatment. It
examines how teleoncology plays a role in
improvising cost effectiveness, reducing
waiting times, improving clinical outcomes.
The paper would also discuss where tele
oncology currently stands in managing
cancer care and its scope for future
improvements.
Introduction: Many centers around the
world have adopted the model of
teleoncology to promote cancer care to
disadvantaged and rural communities. In
regions like northwestern Ontario, only a
handful of oncologists exists, as a result,
patients have no other choice but to travel
long distances to seek expert opinion,
treatment, follow ups. Smaller communities
lack the financial base required for such
service. Many of the rural and remote
communities are First Nation reserves, and a
number of these northern aboriginal
communities have only seasonal road access
in winter or none at all. Long winters, bad
weather, travelling cost, accommodation
cost are some of the obstacles faced by the
patients which add to their woes apart from
the cancer disease they are suffering from.
Teleoncology could be a tangible and

probable solution to all these problems. In

general, its main benefits are assumed to be
able to receive the cancer care without the
dire need of patients and their families to
travel miles which is expensive, leads to
despair, and affects not only the patients
suffering but also their families involved.
However, it is strongly argued that avoiding
the expensive travel for the patients is not
the only benefit that such model brings in
but it also adds to the effectiveness to the
entire rural health system.
The technology: Data in teleoncology may
occur in two ways- store and forward or
asynchronous that involves the exchange of
pre-recorded data between two or more
parties at different times, and the other mode
is the synchronous where it is mandatory to
have the involved individuals to be
simultaneously present for immediate
exchange of information, as in the case of
videoconferencing. To promote security,
data may be supplied in Integrated Service
Digital Network (ISDN) format or any other
encrypted format. A teleoncology service
introduced at the Thunder Bay Regional
Health Science Centre (TBRHSC) in 2001
as part of the overall Telehealth program in
Ontario. The telehealth equipment used by
the TBRHSC network was provided by
Tandberg and Adcom and specifically
designed for ease of use by the NORTH
Network (now a component of the Ontario
Telemedicine Network). The actual
connectivity was provided by Smart
Systems for health (an Ontario Ministry of
Health and Long-Term Care agency) and
Bell Canada. The carrier class is Polycom
MGC-100 Video Conferencing Bridge. The
NORTH Network uses Internet Protocol (IP)
videoconferencing to deliver services. Smart
Systems for Health provides this secure,
private bandwidth to all hospital sites and to
K-Net (the information technology arm of

the Keewaytinook Okimakanak tribal

council