The Power of the Remote Second Opinion

October 30, 2017 | by Michael Easterling

When faced with a cancer diagnosis, friends, family and even physicians will often recommend that a patient get a second opinion. It’s an important step, meant to ensure that all information has been properly evaluated before a course of treatment is determined. In fact, it's to obtain a second opinion that many patients first come to City of Hope.

Now, thanks to advances in technology, City of Hope can offer second opinions to patients who are on the other side of the globe.


Global Expertise

Karen Reckamp, M.D., M.S., co-director of City of Hope’s Lung Cancer and Thoracic Oncology Program, recently consulted on the case of a lung cancer patient in Shanghai, China. There’s nothing especially strange about that. Reckamp consults on plenty of cases. What was remarkable was the fact that she did it from a conference room on City of Hope’s main campus – 6,500 miles from Shanghai.

The patient had already seen three different physicians in her home country, each with a different opinion. One recommended surgery as her best option. Another said chemotherapy was the logical next step.

Reckamp conferred with Chinese physicians through a translator. She reviewed the patient’s medical records and history, and was able to provide her expertise as a thoracic oncologist, recommending a treatment plan that the family and physicians were pleased with.

Reckamp determined the patient was indeed receiving the best treatment option – a popular chemotherapy drug – and recommended a PET (positron emission tomography) scan and a follow-up consult.

“Being able to offer a remote second opinion like this is providing a valuable resource to patients and doctors who are faced with difficult circumstances or choices about their treatment options,” Reckamp said. “A remote, live consultation is preferable. We can learn new information and understand the subtleties and nuances of the disease treatment that may not translate simply from reading the medical record.

“This is a much more flexible, dynamic experience that keeps the patient at the center, and allows us to come to a more congruent decision than just reading paperwork would do.”
 

An International Exchange

Remote second opinions comply with disease treatment protocols outlined by the National Comprehensive Cancer Network (NCCN). The exchange between Reckamp and the physicians in China was made possible through a partnership between City of Hope’s Center for International Medicine (CIM) and GenomiCare Biotechnology, a Chinese company specializing in precision medicine.

Before the late-afternoon consult (Shanghai is 15 hours ahead of Los Angeles), many logistical details had to be managed, explained Roxanna Man, director of International Patient Services.

“There’s an intake process we do to learn as much about the patient’s medical history and diagnosis as possible," she said. "Then we find the most logical City of Hope specialist to bring in.”

The video conference technology that makes such consults possible is based on a Skype for Business platform. All patient information is communicated within a tightly controlled, HIPAA-compliant environment.

“We do a lot up front to make sure that expectations are set appropriately,” said Man, who was born in Hong Kong. “By the time we consult with the patient, we have all the information we need and we ensure that GenomiCare is fully prepared as well. We have to be mindful of the limited time we have (most remote second opinion sessions are only 30 minutes).”

Man said that giving these patients access to City of Hope specialists from the other side of the world is the future of medicine.

“Technology allows us to review digital pathology remotely, so we can have our pathology team collaborate with international pathologists, our radiologists with international radiologists,” she said. “These relationships can change a patient’s outcome.”

Reckamp said she believes that remote consultations and second opinions aren’t going anywhere. They’re part of a new wave in medicine.

“In this world we live in now, we are all connected through the internet and our devices. Diagnosing and treating cancer electronically is a natural evolution,” she said. “It’s not always possible for someone to travel great distances, or have access to the best specialists where they are. If we can help guide them down a different path, we can change their treatment for the better.”

If you would like to schedule a remote second opinion consult with a City of Hope physician, you can contact the Center for International Medicine at 1-800-826-4673, option 9. You can also scan our WeChat QR codes below to chat directly with our patient services team. 
 
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