Congress Abstracts 2006

30

E-CARE: A VIABLE OPTION FOR REMOTE AMBULATORY ONCOLOGY NURSING CARE. Janice Wright, RN, MS, Princess Margaret Hospital, Toronto, Canada; and Brendan Purdy, RN, MN(c), and Sharon McGonigle, RN, MScN, University Health Network, Toronto, Canada.

The rapid increase in the use of Telehealth videoconferencing to facilitate patient consultation is challenging the present nature of oncology nursing practice. This medium offers an innovative option for comprehensive care delivery in ambulatory cancer clinics. It is essential that nurses know and understand the clinical application of this medium in order to provide leadership in developing, applying and managing e-care oncology programs.

The Allogeneic Blood and Stem Cell Program (ABSCP) at Princess Margaret Hospital (PMH), Toronto, Canada performs 75 transplants annually and manages approximately 600 outpatients. The majority of patients reside in communities more than 100 miles from PMH. The ABSCP Nurse Practitioner sought to determine whether Telehealth videoconferencing would be a viable service delivery model to meet the complex needs of their remote patients and care partners.

The ABSCP introduced Telehealth into their clinic as a pilot project in early 2005. Patient selection criteria included: complexity of symptoms, therapeutic plan and geographical remoteness. Their progress was monitored via videoconferencing for up to 12 months with a goal of improving symptom management through partnered supportive care in their home communities. Nursing-Sensitive Patient Outcome measures included: symptom experience in relation to Graft vs. Host Disease; functional status; and economic impact.

Findings from the pilot study demonstrate the effectiveness of Telehealth through:

1. Enhanced monitoring capability for mucositis management with high-resolution cameras.
2. Improved assessment of patients' health status permitting tailoring of clinical interventions through more frequent appointments.
3. Increased patient satisfaction due to increased activity tolerance and improved role functioning with improved treatment compliance.
4. Improved access to care for patients in their distant communities - thereby reducing out of pocket family costs, commuting time, and a sense of rural isolation.

The ABSCP team successfully integrated Telehealth into its clinical nursing practice as an innovative option for complex symptom management and enhanced treatment compliance within a remote patient population. The findings demonstrate that telehealth videoconferencing improved Nursing-Sensitive Patient Outcomes, increased patient satisfaction, and decreased health care costs. This initiative has changed nursing practice in ambulatory clinics at PMH and has implications for the management of remote oncology patients.