Consultation via telemedicine and access to operative care for patients with head and neck cancer in a Veterans Health Administration population

Background. The purpose of this study was to evaluate a telemedicine model that utilizes an audiovisual teleconference as a preoperative visit. Methods. Veterans Health Administration (VHA) patients with head and neck cancer at 2 remote locations were provided access to the Palo Alto Veterans Affairs (PAVA) Health Care System otolaryngology department via the telemedicine protocol: tissue diagnosis and imaging at the patient site; data review at PAVA; and a preoperative teleconference connecting the patient to PAVA. Operative care occurred at PAVA. Follow-up care was provided remotely via teleconference. Results. Fifteen patients were evaluated. Eleven underwent surgery, 4 with high-grade neoplasms (carcinoma). Average time from referral to operation was 28 days (range, 17-36 days) and 72 (range, 31-108 days), respectively, for high-grade and low-grade groups. The average patient was spared 28 hours traveling time and $900/patient was saved on travel-related costs. Conclusion. A telemedicine model enables timely access to surgical care and permits considerable savings among select VHA patients with head and neck cancer. (C) 2016 Wiley Periodicals, Inc.