Cancer Diagnosis in the Virtual Space

Since the end of 2011 there has been a “Tumorboard” at the Landesklinikum- Graz, where doctors discuss the situation of patients and decide on the appropriate kind of therapy.

Once a week, every Wednesday at half past one, doctors meet in the virtual space. The Oncologists of the Landesklinikum Graz speak about patients with cancer to colleagues who are specialists at the Tumorboard. Doctors take their place in the video room at the institute for Oncology. Doctors from other fields: from Surgeons to Gynaecology and Andrology are included via an encrypted line. One doctor is the moderator of the meeting in which one patient after another is introduced by the doctor in his role as “Case Manager” and then the patient’s case is discussed.

A tool for more efficiency
“We get all the relevant medical findings and pictures from the hospital’s information system, and then develop the ideal therapy“, says Karin S. Kapp. She is head of the university clinic for Radiation Therapy and Radio Oncology. “The Tumorboard is a tool for more efficiency and as the diagnosis can be made faster, the recommendation for the best therapy can be done faster.” Time is a very important factor when it comes to cancer as diagnosis and treatment should start very soon after a surgery or a finding.

In addition, travelling and scheduling of appointments is no longer necessary. Another advantage is an improvement in education as it is possible for medical students to attend the meeting in the virtual space. Kapp: “If the hospital of Leoben attends the meeting, more than 30 people are included.”

150000 Euro Solution
The Tumorboard was developed together with Cisco. They have adapted their telepresence solution for use in medicine. In total the cost was around €150.000,-. “The imaging of X-Ray pictures and computer tomography pictures is done in full HD”, Achim Kaspar, Head of Cisco Austria explains. Doctors from nearby hospitals are either connected via a big video system (video conference room) or use a personal system, a solution for the computer or notebook.

Borderless Tele-medicine
The solution was created for the Styrian Hospital Corporation (KAGes), “But it could be extended outside the borders of the country and even used internationally”, says Kaspar. International conferences with experts from other countries could be arranged. “The only thing we would have to do is to open our firewalls”, Karl Kocevar, Head of IT of KAGes mentions.
30 years obligation of data storage

As findings came via postal service or fax in earlier days, and some documents where incomplete, now they get fed into the digital system immediately by the hospitals and can be called everywhere. The Tumorboard is linked to the patient information system that was reduced to only one system from the original nine different systems. “We have already transferred our archives to a newer storage media facility five times because there is an obligation in the medical system to store data for at least 30 years. The 1086 terabyte archive is said to be one of the biggest data collections in the world”, Kocevar says.

The Tumorboard is an ideal example of “collaboration”(as this kind of teamwork is called in medicine.) It is also an example of the effective use of telematics in medicine which has been talked about for decades. The ideal standard is, and that would count for all fields of medicine, if the patient’s doctor sits in the “headquarters” and all the other doctors who can give support get connected.

Cancer increase
The reason that the clinic for Radiation Therapy and Radio Oncology was the first to use the system was because of a new law introduced in 2008. Since then tumour findings had to be discussed by more than one doctor, the doctors had to travel throughout the country and visit hospitals.

Furthermore, this field of medicine always had a high affinity to technology. “We are very technology and software driven”, Kapp says during the tour through her institute, where she showed the millions of Euros worth of expensive devices to futurezone.

“Cancer will have increased to about 50 percent by 2020“, Kapp says. The reasons for that include the current lifestyle, environmental influences and also medicine itself, as diseases are recognised earlier nowadays. Today, already ten patients per day receive treatment in Graz this equals a total of 50 hours of radiotherapy.