Purpose: Veteran prostate cancer patients at the Richard L. Roudebush VAMC may travel as long as 5 hours each way for routine follow-up appointments at the Radiation Oncology Clinic (Peoria, Illinois; 211 miles each way). We are able to offer telehealth clinic visits at the patient’s community-based outpatient clinic (CBOC), which completely address the follow-up needs of our patients, while saving them travel time and money and improving satisfaction.
Methods: We started our telehealth program in Radiation Oncology with prostate cancer patients, because they not only represent 40% of our total patient load, but also because a digital rectal examination (DRE) is not necessary for follow-up as long as the patient does not have evidence of biochemical failure. We offer a telehealth follow-up visit to all uncomplicated prostate cancer patients at the time of scheduling of recall visit. A PSA is drawn at the CBOC, and the CBOC nurses administer our AUA (American Urological Association) and IIEF (International Index of Erectile Function) questionnaires to the patients. We performed a data run on the VISN Data Warehouse, looking for primary stop codes in radiation oncology and secondary stop codes in telehealth for the ICD-9 code for prostate cancer, including patient zip code. I used a zip code distance calculator (zip-codes.com) to obtain the distance between the patient’s zip code and that of Richard L. Roudebush VAMC in Indianapolis. I then applied the travel pay of $0.41 per mile to the round-trip mileage to come up with an approximate travel savings for the patient.
Results: We have successfully treated 31 patients between 3/13/13 and 5/19/14 using telehealth. Barriers included development of appropriate clinic names and adding additional telehealth clinic sites. Ninety-eight percent of patients were satisfied with their experience and wished to continue with telehealth follow-up visits. Approximate savings in travel pay for this group of 31 patients was $3,035.
Conclusions: It is both feasible and cost-effective, as well as veteran-centric to offer telehealth follow-up visits for radiation oncology patients after radiation treatment.