Using TelesynergyÃ^® to Improve Access to Clinical Trials at an Underserved Community Based Hospital

Article Outline

• Purpose/Objective(s)
• Materials/Methods
• Results
• Conclusions
• Copyright

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Purpose/Objective(s) 

Significant disparities in cancer detection, treatment, outcomes and participation in clinical trials are well documented and exist within racial/ethnic minorities and low income patients. In 2003, Centinela Freeman Regional Medical Center (CFRMC) received a grant from the National Cancer Institute to evaluate and overcome cancer disparities. To facilitate the development of this program, a TelesynergyÂ^® integrative media telemedicine system was established to link our facility to a NCI-designated Comprehensive Cancer Center, as well as other cancer centers around the country.

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Materials/Methods 

A TelesynergyÂ^® system was installed at our community hospital campus, Centinela Freeman Regional Medical Center (CFRMC), our mentor institution at the University of Southern California/Norris Cancer Center (USC/Norris); and at various other cancer centers around the country. The system consists of a video conference system, multiple video monitors, a high resolution grayscale view box, a microscope with video camera, a document camera capable of viewing sheet film and other printed documents, a patient exam camera, a VCR/DVD burner, and a high resolution film scanner. The system is used for weekly administrative meetings between us and our mentor institution, joint tumor boards between the hospitals, educational lectures which are transmitted among other TelesynergyÂ^® sites, navigator training sessions, and teleconferences with other Cancer Disparities Research Program (CDRP) sites to discuss ongoing protocol design as well as challenges with patient enrollment in cooperative group trials.

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Results 

TelesynergyÂ^® was instrumental in the creation of a clinical trials infrastructure in the time period of less than a year. Meetings between CFRMC and USC/Norris were particularly helpful in the selection of appropriate RTOG trials as well as overcoming barriers to the credentialing process for certain trials. Currently six RTOG trials and one investigator initiated trials are open for patient enrollment at CFMRC. During the first year, nine radiation oncology patients were enrolled in clinical trials. Seven of these patients were enrolled in RTOG sponsored trials. TelesynergyÂ^® was also utilized to address ongoing patient management issues which included review of complex IMRT and brachytherapy plans. In essence, TelesynergyÂ^® created an environment where the expertise and resources of a university radiation therapy department were readily accessible by a community hospital.

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Conclusions 

TelesynergyÂ^® is a powerful tool which improves communication between university cancer centers and community hospitals. These interactions have helped to develop the infrastructure necessary for successful clinical trial participation and trial development.