Developing the Native People for Cancer Control Telehealth Network

Abstract

Objective: We aimed to develop a telehealth network to deliver postdiagnosis cancer care clinical services and education to American Indian and Alaska Native patients, their families, and their healthcare providers. We also sought to identify the challenges and opportunities of implementing such a telehealth-based application for this rural and underserved population. Materials and Methods: We followed a participatory formative evaluation approach to engage all stakeholders in the telehealth network design and implementation. This approach allowed us to identify and address technical and infrastructure barriers, lack of previous experience with telehealth, and political, legal, and historical challenges. Results: Between September 2006 and August 2009, nine tribal clinics in Washington and 26 clinical sites in Alaska had participated in the telehealth network activities. Network programming included cancer education presentations, case conferences, and cancer survivor support groups. Twenty-seven cancer education presentations were held, with a total provider attendance of 369. Forty-four case conferences were held, with a total of 129 cases discussed. In total, 513 patient encounters took place. Keys to success included gaining provider and community acceptance, working closely with respected tribal members, understanding tribal sovereignty and governance, and working in partnership with cultural liaisons. Conclusion: The telehealth network exceeded expectations in terms of the number of participating sites and the number of patients served. Following a participatory formative evaluation approach contributed to the success of this telehealth network and demonstrated the importance of community involvement in all stages of telehealth system design and implementation.

Successful Implementation of a Telemedicine-Based Counseling Program for High-Risk Patients With Breast Cancer

“…Owing to barriers such as lack of access to hospitals because of long distances, shortage of primary care physicians and specialists, 3,4 a high turnover rate of health care professionals, 4,5 and long waiting periods, 3,6 the health care model in rural Alaska consists of village medical clinics that are linked to larger regional medical centers staffed by health care professionals. Cancer is the second leading cause of death among Alaskan natives older than 45 years 7 ; however, the aforementioned barriers preclude access to appropriate counseling services for high-risk patients, screening tests, follow-up and referral for abnormal test results, and compliance with recommended treatment.…”

TelePain: A Community of Practice for Pain Management

“…This “multiplier effect” broadens educational impact for community providers of many specialties (e.g., physicians, nurses, dentists, pharmacists, PAs, social workers, home health workers, addiction counselors, physical therapists) enabling locally shared community expertise actively supported by experts. Telehealth with direct health professional student participation as a means to deliver expert content and curriculum to an extended community health system has been used at UW since 1994 [12,13]. To address the UW’s geographically dispersed medical student clinical rotations and to provide a service to the regional community physicians who act as preceptors, the UW School of Medicine added interdisciplinary, case based pain management teleconference consultation as a pilot program through its Telehealth service, called UW TelePain, in 2008 [14].…”

Development and implementation of a telehealth-enhanced intervention for pain and symptom management

“…26,27 The project included 9 tribal clinics in Washington state and 26 clinics in Alaska. The telehealth system was found to be a successful method for delivering services to tribal clinics.…”