"Press '1' to Speak to Your Next Patient"

OncLive Chairman,

Mike Hennessy

In this month’s issue of Oncology Business Management, we take you to Hawaii and Alaska to peel back the curtains on how oncologists in remote corners of the United States have innovated to keep their businesses vibrant and effective.

In the fiftieth state, for example, oncology is all about building relationships with fellow medical practitioners in the community. Our practice profile this month puts a spotlight on OnCare of Hawaii, which relies heavily on its physician network for referrals and does almost no advertising. Physicians in these idyllic islands know the importance of keeping good relations.

In a separate cover story, we take a look at the business of oncology in Alaska, where many patients must travel great distances for treatment, sometimes by plane and snowmobile. In this state, oncologists have innovated by using telemedicine to communicate remotely with patients, primary care physicians, and nurses. This helps to compensate for the shortage of doctors and the tremendous distances separating the sparse Alaskan population. In telemedicine, a healthcare worker is physically present with the patient while the oncologist participates via monitor.

It may sound unlikely to some, but tele-oncology may be coming to many locations in the lower 48 in the near future, for various reasons.

In the mid-1990s, the University of Kansas Medical Center (KUMC) replaced its timeconsuming and expensive “fly-in” oncology service with a distance treatment experiment that quickly proved its worth. Tele-oncology has improved access to specialty services and has been well received by patients, and its use endures at KUMC to this day, officials there have stated.

Now, payers and The Centers for Medicare & Medicaid Services (CMS) are incorporating incentives for use of telemedicine into their payment plans, on the theory that it cannot fail to save money and improve efficiencies not only between patient and oncologist, but among all health team members whose decisions affect patient outcomes and the cost of care.

A recent CMS study of 2014 data found that only 27% of Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program achieved enough savings and quality improvements to qualify for financial incentives, and only 20% of these ACOs employed telemedicine services. With CMS trying to funnel 30 percent of Medicare payments through alternative payment models this year, and 50 percent by the end of 2018, use of telemedicine is poised to soar, according to a report by the healthcare consultants Foley & Lardner. Indeed, the telemedicine market on a global scale measured $14.3 billion in 2014 and is forecast to hit $36.2 billion in 2020, Foley & Lardner said.

Just as old-time journalists used to phone in their stories, oncologists may soon be phoning in their next patients. It may not be the ideal patient-doctor experience; on the other hand, technology once again is extending the reach and power of modern medicine. Read all about it in this month’s issue of Oncology Business Management.