Innovation: Development of a Virtual Radiation Oncologist Consultation Service

Framework Development: Standardizing Definition of Advanced Practice Radiation Therapy Activities for Clinical Workload Quantification

“…The AP activities collected were diverse and from every time-point of a typical radiation therapy patient care pathway: 1) triage, 2) new patient consultation: obtaining consent, physical exam, 3) treatment planning: technical consultation for planning, delineation of target, organ-at-risk (OAR) or field placement, 4) treatment delivery: image assessment, and 5) weekly review or follow up visits. The APRTs also provided a list of activities performed under a medical directive: ordering diagnostic imaging, lab work and medications independently and conducting virtual new patient consultations for patients that live from a distant from their cancer centre [15] . Finally the brachytherapy APRTs listed AP activities they performed in the brachytherapy patient care pathway.…”

“…The implementation of the service resulted in significant time and cost savings for these patients residing, on average, 600 km outside of the Local Health Integration Network (LHIN). [15] It was also identified that there is a distinct skillset and competencies required to conduct virtual patient interactions compared to those conducted in-person. [20] , [21] To ensure patient safety, additional training is required for the use of new technology and a modified approach to virtual assessment.…”

A Canadian experience of palliative advanced practice radiation therapy TIPS: Training, implementation, practice and sustainability

“…As recognized leaders on the pRT team and beyond, pCSRTs can influence jurisdictions to achieve necessary changes and improvements in practice/processes, as demonstrated by pCSRTs' research and knowledge translation, academic contribution, and stakeholder experiences [6,12,14,18,21,[27][28][29][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Table 3 summarizes the metrics used by pCSRTs to illustrate their influence, along with the methodology used to gather information.…”

The palliative clinical specialist radiation therapist: A CAMRT White Paper

“…An example of this was demonstrated by a pCSRT at a large academic cancer center in Ontario, who implemented the use of videoconferencing technology for patients diagnosed with brain and/or oligo-metastases for SBRT consultations with an RO. The videoconferencing demonstrated many benefits including a savings of seven hours of transportation time and $100 per patient, as well as saving clinic space using a virtual environment 37 .…”

“…This virtual consultation process has provided equivalent, safe, and timely care, and enhanced access to SBRT services for geographically distant patients diagnosed with brain metastases, oligometastatic disease, and early-stage lung cancer 37 . Ongoing research will help reveal further costs and benefits to a health system, compare outcomes, and assess the acceptability of the approach by patients.…”