1. Hematology and Oncology uses of Telemedicine (Anatomy of an Outlier) Jorge J. Nieva M.D. Billings Clinic Cancer Center

2. Confessions of a telemedicine doc TOP 5 telemed users PRISM research project794 Oncology112 Neurology 44 Pulmonary 41 Dietician 25

3. Why use Telemed? Research related visits Discussions on important decisions requiring family participation Reducing patient travel costs to outreach sites Monitoring labs in hematology patients Palliative care visits for patients who have no hospice access

4. Research Related Visits Protocols are complicated and inflexible Outreach visits fall out of sequence with research visits For NCI sponsored research, telemed is an adequate physician office visit.

5. Serious discussions Patients with cancer are often elderly Many decisions are made in conjunction with family members Telephone calls exclude family….and lead to more telephone calls.

6. Patient Travel costs Outreach clinic visits and chemotherapy are often out of sequence Some patients drive 100+ miles to get to an outreach site.

7. For patients who just need to discuss labs….. Immune thrombocytopenia Polycythemia vera Chronic Myeloid Leukemia Essential Thrombocytosis Autoimmune Hemolytic Anemia

8. Cancer Outreach Clinics

9. Thank You !