Delivering chemotherapy closer to home in community hospitals using the Tele Oncology and Tele Nursing model is now well established as a model in North Queensland since its initial inspection in 2007. This model has been shown to be safe, cost effective and efficient. The Queensland Govt. has modelled its Queensland Remote Chemotherapy Supervision (QReCS) programme on this concept. Moving a step further, to improve access to clinical trials for rural, regional and rare cancer patients, the Australasian Tele-trial Model has been developed by the Clinical Oncology Society of Australia (COSA) in consultation with clinical trial sponsors, clinicians, health administrators and regulatory bodies.
Using this model, tele-trial clusters are developed by linking primary sites with satellite sites via telehealth. This collaboration between oncologists can lead to a connected health care system across Australia and enable improved local access to clinical trials for disadvantaged patients. This model is useful for rare cancers even within the same metro setting thus improving rate of recruitment. COSA’s national guideline outlines 14 requirements for safe conduct of clinical trials using this model. This include Selection of satellite sites and suitable trials including accreditation of sites, supervision plans and site visits, workforce, GCP, role and responsibilities, training for individual staff, site initiation meetings and trial updates, technology and support, participant screening and recruitment, obtaining participant consent, medication handling, managing and reporting serious adverse events, patient reported outcomes, documentation and reporting, financial considerations, regulatory considerations, Indemnity, Insurance and clinical trial agreements.
While state and commonwealth governments are expected to streamline legal, ethical and regulatory processes and develop new funding models, successful implementation of the ground relies on clinicians, trial groups, industry and cancer centres.