Native People for Cancer Control Telehealth Network Roy Colven Cara Towle Lisa R Thomas HollyAnna Pinkham March 12, 2007.

Native People for Cancer Native People for Cancer Control Control

Telehealth NetworkTelehealth Network

Roy ColvenRoy Colven

Cara TowleCara Towle

Lisa R ThomasLisa R Thomas

HollyAnna PinkhamHollyAnna Pinkham

March 12, 2007March 12, 2007

Native People for Cancer Control Native People for Cancer Control Telehealth Network (NPCCTN): Telehealth Network (NPCCTN):

Overall GoalOverall Goal• To reduce the gap between American To reduce the gap between American

Indians/Alaska Natives and other Indians/Alaska Natives and other groups in cancer caregroups in cancer care

• To improve the results of cancer To improve the results of cancer treatment in American Indians and treatment in American Indians and Alaska NativesAlaska Natives

• To support Native cancer survivors, To support Native cancer survivors, their health care providers, and their their health care providers, and their familiesfamilies

NPCCTN FundingNPCCTN Funding

• Office for the Advancement of Office for the Advancement of Telehealth (Health Resources and Telehealth (Health Resources and Services Administration)Services Administration)

• $250,000 per year x 3 years$250,000 per year x 3 years

NPCCTN PartnersNPCCTN Partners

• South Puget Sound Intertribal Planning South Puget Sound Intertribal Planning AgencyAgency

• Alaska Native Tribal Health ConsortiumAlaska Native Tribal Health Consortium• Individual Tribes and their communitiesIndividual Tribes and their communities• University of WashingtonUniversity of Washington• Seattle Cancer Care AllianceSeattle Cancer Care Alliance

• University of Washington MedicineUniversity of Washington Medicine• Children’s Hospital and Regional Medical CenterChildren’s Hospital and Regional Medical Center• Fred Hutchinson Cancer Research CenterFred Hutchinson Cancer Research Center

NPCCTN CollaborationsNPCCTN Collaborations• Tribal CouncilsTribal Councils• Tribal organizationsTribal organizations• Tribal Health Care ClinicsTribal Health Care Clinics• Urban Indian Health Care Facilities, e.g., Urban Indian Health Care Facilities, e.g.,

Alaska Native Medical Center, Alaska Federal Alaska Native Medical Center, Alaska Federal Health Care Access Network, Seattle Indian Health Care Access Network, Seattle Indian Health BoardHealth Board

• Cancer treatment facilitiesCancer treatment facilities• NCI-funded Cancer Information ServiceNCI-funded Cancer Information Service• Washington State Comprehensive Cancer Washington State Comprehensive Cancer

Control Steering CommitteeControl Steering Committee

TelemedicineTelemedicine

• The use of electronic information and The use of electronic information and communications technologies to provide communications technologies to provide and support health care when distance and support health care when distance separates the participants.” IOM 1996separates the participants.” IOM 1996

TelehealthTelehealthTelehealth encompasses a broader definition of Telehealth encompasses a broader definition of

remote healthcare that does not always involve remote healthcare that does not always involve clinical services. clinical services.

• VideoconferencingVideoconferencing• Transmission of still imagesTransmission of still images• E-health including patient portalsE-health including patient portals• Remote monitoring of vital signsRemote monitoring of vital signs• Continuing medical educationContinuing medical education• Nursing call centersNursing call centers• … … are all considered part of telemedicine and are all considered part of telemedicine and

telehealth.telehealth.American Telemedicine AssociationAmerican Telemedicine Association

http://http://www.americantelemed.orgwww.americantelemed.org//

NPCCTN ActivitiesNPCCTN Activities• Utilize telehealth technologies to Utilize telehealth technologies to

provide education and consultative provide education and consultative services and support to cancer patients services and support to cancer patients and their providers:and their providers:• Comprehensive Care PlansComprehensive Care Plans• Pain related to cancerPain related to cancer• Psychological issues related to cancer, Psychological issues related to cancer,

including support group creationincluding support group creation• Legal issues related to cancer diagnosis Legal issues related to cancer diagnosis

and end-of life issuesand end-of life issues• End of life care and planning End of life care and planning

NPCCTN ActivitiesNPCCTN Activities

• Facilitating virtual tumor board participationFacilitating virtual tumor board participation• Supporting patient referrals and returns Supporting patient referrals and returns

coordinationcoordination• Sharing educational resources between Sharing educational resources between

academic, clinical care, and tribal partners, academic, clinical care, and tribal partners, such as continuing education and trainingsuch as continuing education and training

• Continuous evaluation of services to Continuous evaluation of services to determine value, satisfaction and impactdetermine value, satisfaction and impact

NPCCTN StaffNPCCTN Staff• Dedra Buchwald, MD, Principle InvestigatorDedra Buchwald, MD, Principle Investigator• Roy Colven, MD, Co-Investigator/Project DirectorRoy Colven, MD, Co-Investigator/Project Director• Cara Towle, RN, Project Manager and Technical LiaisonCara Towle, RN, Project Manager and Technical Liaison• HollyAnna Pinkham (Yakama), Community Outreach Specialist HollyAnna Pinkham (Yakama), Community Outreach Specialist

for Washington for Washington • Lisa R Thomas, PhD (Tlingit), Research Scientist and Lisa R Thomas, PhD (Tlingit), Research Scientist and

Community Outreach Specialist for AlaskaCommunity Outreach Specialist for Alaska• Rande Gray, Technical Specialist Deborah Friedman, MD, Rande Gray, Technical Specialist Deborah Friedman, MD,

Consultant in Care of Cancer SurvivorsConsultant in Care of Cancer Survivors• Fransing Daisy, PhD (Cree), Mental Health ConsultantFransing Daisy, PhD (Cree), Mental Health Consultant• Ron Whitener, JD PhD (Squaxin Island), Legal ConsultantRon Whitener, JD PhD (Squaxin Island), Legal Consultant• Anajana Kundu, MD, Pain ConsultantAnajana Kundu, MD, Pain Consultant• Ardith Doorenbos, PhD RN, End of Life ConsultantArdith Doorenbos, PhD RN, End of Life Consultant• George Guilmet, PhD, Program EvaluationGeorge Guilmet, PhD, Program Evaluation

NPCCTN in WashingtonNPCCTN in Washington

• Prospective participants: SPIPA tribes + Prospective participants: SPIPA tribes + QuinaultQuinault

• Next steps: Next steps: • Meet with individual tribesMeet with individual tribes• Understand needs at each partner siteUnderstand needs at each partner site• Determine which NPCCTN services may benefit Determine which NPCCTN services may benefit

each partner siteeach partner site• Determine technical needsDetermine technical needs• Tribal resolution at each partner siteTribal resolution at each partner site• Collaboratively establish NPCCTN service protocolsCollaboratively establish NPCCTN service protocols

NPCCTN in Washington: NPCCTN in Washington: Technical PlansTechnical Plans

• K-20 Educational Telecommunications K-20 Educational Telecommunications NetworkNetwork• 48 Public Baccalaureate sites• 71 Community/Technical Colleges• 307 K-12 sites• 65 Library sites (proposed)• 15 Private Baccalaureate sites (proposed)

NPCCTN in Washington: NPCCTN in Washington: Technical PlansTechnical Plans

• Benefits of K-20 Network membershipBenefits of K-20 Network membership• Provides significant bandwidth for a fraction of

commercial costs for all rural sites.• Allows access to K-20 bridge for multi-point

conferences.• Provides toll-free calling within network or to Seattle

area.• Open network allows out of system calls.• Result: Increased sustainability beyond grant funding.

Alaska NPCCTN updatesAlaska NPCCTN updates

Alaska PartnersAlaska Partners

• CANCER IS THE LEADING CAUSE OF CANCER IS THE LEADING CAUSE OF DEATH FOR ALASKA NATIVESDEATH FOR ALASKA NATIVES

• 229 federally recognized Tribes229 federally recognized Tribes• 16% of the population16% of the population• 60% live in small remote communities 60% live in small remote communities

generally withoutgenerally without connection to a road connection to a road system system

• Needs and resource assessmentNeeds and resource assessment

Meeting with our Alaska partnersMeeting with our Alaska partners

• January 2007January 2007• Alaska Native Tribal Health ConsortiumAlaska Native Tribal Health Consortium

• Alaska Native Health ResearchAlaska Native Health Research

• Alaska Native Medical CenterAlaska Native Medical Center

• Alaska Federal Health Care Access Alaska Federal Health Care Access NetworkNetwork

• American Cancer Society, AlaskaAmerican Cancer Society, Alaska

Alaska Native Health CareAlaska Native Health Care

• Alaska Tribal Health SystemAlaska Tribal Health System• Village-based clinicsVillage-based clinics• Regional hospitalsRegional hospitals• Sub-regional clinicsSub-regional clinics• Alaska Native Medical CenterAlaska Native Medical Center• Contract care (Seattle)Contract care (Seattle)

• ANTHC is the largest Tribal self-governance ANTHC is the largest Tribal self-governance entity in the USentity in the US

• Telehealth is recognized as an essential Telehealth is recognized as an essential component to health care in Alaskacomponent to health care in Alaska

NPCCTN and Alaska – service NPCCTN and Alaska – service providersproviders• Virtual tumor boardsVirtual tumor boards• CME for service providersCME for service providers• Training for community health aidesTraining for community health aides• Coordinate transfer of cancer patients Coordinate transfer of cancer patients

between Alaska and Seattlebetween Alaska and Seattle• Follow-up care for patients in the bushFollow-up care for patients in the bush• Survivorship careSurvivorship care• Palliative carePalliative care• Support groupsSupport groups

Next stepsNext steps

• Meet with Community Health AidsMeet with Community Health Aids

• Meet with regional and sub-regional Meet with regional and sub-regional clinicsclinics

• Meet with village clinicsMeet with village clinics

• Meet with Alaska Native cancer patients Meet with Alaska Native cancer patients and their familiesand their families

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