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. © 2016 Wiley Periodicals, Inc. Head Neck 38: 925–929, 2016