UMGCC NEWS

New Telemedicine Program Brings Top-Notch Cancer Care to More Marylanders

Telemedicine session at UMGCC

With the help of a new University of Maryland Greenebaum Cancer Center (UMGCC) telemedicine program, patients receiving cancer treatment at selected 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 UMGCC. Patients can remain in their communities, but still receive the benefits of UMGCC.

"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 UMGCC'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 UMGCC's Department of Radiation Oncology in downtown Baltimore to consult and review cases with physicians in affiliated radiation oncology community practices in Anne Arundel, Montgomery and Howard Counties and together decide the best treatment plan for patients and together monitor patients' progress. Patients treated at affiliated community radiation oncology centers have increased opportunities to benefit from all that UMGCC 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., Vice Chairman of UMGCC's Department of Radiation Oncology. Dr. Suntha is also an associate professor of Radiation Oncology at the University of Maryland School of Medicine.

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

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

Mohan Suntha, M.D.

"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 go on 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, UMGCC has set up radiation oncology community practices at several locations: Central Maryland Oncology Center in Howard County, Montgomery General Hospital's Helen P. Denit Center for Radiation Therapy, and at Baltimore Washington Medical Center's Tate Cancer Center.

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

The practices were all 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 Montgomery General Hospital or 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 UMGCC in Baltimore. UMGCC'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 UMGCC and our overall cancer vision to provide the best cancer care for Marylanders," Dr. Suntha said.

Program Funding

The new 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 UMGCC 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 has previously only been available in Baltimore. Working with MSHN, UMGCC would like to extend this program to other regions of the state.

Benefit to Patients and Doctors

Dr. Suntha cites the UMMC'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 UMGCC 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 UMGCC and went back to our affiliated community practice to receive his radiation therapy."

Luther L. Ampey III, M.D., medical director of the Helen P. Denit Center for Radiation Therapy at Montgomery General Hospital and assistant professor of Radiation Oncology at the University of Maryland School of Medicine, said that patients also benefit because their doctors get many opinions on their cases, not just one.

"Whenever we can collaborate and get many opinions on how to manage a case, it can generally spark ideas and increase creativity. The more minds you can put to a case, the more angles that can be discussed and pursued," Dr. Ampey said. "It absolutely keeps me up-to-date on the clinical trials that are being offered through UMGCC."

The telemedicine program also helps him to receive timely feedback on his cases. Video-conferencing allows interactions such as X-ray film review, slide presentations, and treatment plan collaboration by numerous clinicians and multiple sites to be as integral a part of the patient discussion as they would be in a typical, single-site conference. "Without telemedicine I would have had to pick up the phone and present the case all the way through, but with telemedicine I can get almost immediate feedback," said Dr. Ampey. "We can have a discussion right away so I can get a plan formulated early rather than chase down some of that later. It speeds up the whole process and removes geographic distance as a barrier to effective academic discussion."

The Future of Telemedicine

"Telemedicine is in its infancy here at UMGCC, 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 UMGCC 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 UMGCC 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.

This page was last updated on: September 29, 2009.