Pilot Study of a Radiation Oncology Telemedicine Platform

Abstract

Purpose: A pilot study was undertaken to develop an integrated telemedicine platform for radiation oncology at Memorial Sloan-Kettering Cancer Center (MSKCC) and its regional sites. The platform consisted of a computer system with simultaneous display of multiple live data portals including 1) video-conferencing between physicians, 2) radiology, and 3) radiation treatment-planning system (RTPS). Methods and Materials: Two MSKCC regional centers were set up with a widescreen monitor, a dedicated computer, and a web camera with microphone. Each computer ran a Microsoft operating system, utilized video-conferencing software, and connected to the MSKCC Ethernet. This allowed for access to the health information system, radiology (web-based picture archiving and communication systems), RTPS, shared network drives and the internet. Results: After 3 months, physicians at two MSKCC sites were successfully able to implement the proposed telemedicine platform. A small sample of cases (prostate, breast, head and neck, and anal cases) were tested. Radiology images, radiation treatment volumes and plans, and portal images were reviewed. Side-by-side comparison of contouring techniques was performed. The platform allowed physicians to remotely review details of cases efficiently. The interactions of the telemedicine platform improved clinical understanding of each case and often resulted in contouring changes. Conclusion: From this experience, we feel that telemedicine could have a significant clinical impact on patient care, especially at centers with satellite clinics. The future goal of the system will be the development of a virtual tumor board for radiation oncologists. We envision the simultaneous display of multiple clinical components, including face photo, pathology, tumor images/videos of procedures, radiology, RTPS, and anatomy/contouring databases, on one screen surface.