Mumbai: How Tata Memorial Hospital is saving lives remotely and cutting queues

Jul 05, 2017, 08:15 IST | Rupsa Chakraborty

Survey shows 78 pc of those who accessed Tata Memorial Hospital's expert opinion portal found advice useful; over 11,000 patients from 22 nations benefitted without having to come to Mumbai

At any point in time, hundreds of patients are seen waiting for a chance to consult cancer specialists at Tata Memorial Hospital. File pic
At any point in time, hundreds of patients are seen waiting for a chance to consult cancer specialists at Tata Memorial Hospital. File pic

For cancer patients who want a second opinion from Tata Memorial Hospital but cannot afford to travel to Mumbai, there is an easier way. You can now get the best of advice from the renowned cancer centre, all at the click of a button.

Getting an appointment at Tata Memorial Hospital (TMH) can be close to impossible, with thousands of patients of vying for limited slots. As many as 60,000 new patients are registered for treatment in the hospital every year. Many cannot afford to live in Mumbai for the duration of the treatment, and merely visit the hospital for a second opinion - the hospital gets 1,000 such patients every month.

To address the overcrowding of patients and to help as many patients as possible, the hospital launched a service to provide second opinions online on www.navya.care. While it may take days to weeks to get an appointment in person at the hospital, with this service, patients can get an expert opinion on their case within one or two days, and for a reasonable processing fee - Rs 6,500 for Indian patients and $150 for foreign patients. Patients below the poverty line get free consultation.

Since the hospital started the service in association with Navya Network and the National Cancer Grid in 2014, it has been used by as many as 10,779 patients from 22 different countries, including the US and UK.

78% follow through
While this service is no doubt a relief for patients, it also seems to have the approval of their doctors, with a recent survey showing that in 78 per cent of the cases, local doctors treating the patient accept the second opinion from Tata and follow the recommended line of treatment.

This study was conducted among 914 patients who registered with the service between July 2016 and March 2017. From the 90 per cent who responded, 78 per cent of patients said they had followed treatments recommended by Navya.

"The finding that a high proportion of the patients are sharing the reports with their treating oncologist and that most proceed with the recommended treatments, demonstrates that the online service has wide approval among both patients as well as local physicians and oncologists," said hospital director Dr Rajendra Badwe.

How does it work?
Doctors' opinions are based on pathology reports and radiology tests like CT scan, PET scans, or MRI, which patients can send over to Navya. "We use the patient's medical reports and consult the country's best experts and our databases of medical research and outcomes of similar patients," said Gitika Srivastava, founder of Navya.

Once the test reports and the patient's medical history is received, a patient advocate or assistant from Navya presents it to the relevant experts for their opinion. The doctors then prepare a report that answers the patient's questions in layman's terms.

Special cases
In case there is lack of clarity in the test reports, the experts will recommend fresh tests at established laboratories where patients can mail their samples.

In other cases, where the cancer has metastasised (spread to other sites in the body), the treatment plan is formulated by a tumour board at Tata. A tumour board typically consists of a diagnostic radiologist, pathologist, surgeon, medical oncologist and a radiation oncologist.

"Finally, there are some cases for which online opinions are not feasible, and in-person consult is strongly recommended," said Srivastava.

Such patients will be referred to one of the 108 cancer centres that are associated with the National Cancer Grid, such as Tata, Adyar Cancer Institute, AIIMS and others.

Helping patients across the world

'Doctors responded within 24 hours'
Who: Amitabh Das, Odisha
Diagnosis: Oral cancer
When Amitabh Das was diagnosed with oral cancer last year, doctors in Bhubaneshwar had contradictory advice. "Here, junior doctors were asking us to wait for a week. When I heard that Navya's senior oncologists would review the case and respond with 24 hours, I was very doubtful. Within an hour of my registration, a patient advocate from Navya called and explained the complete process to me," said Debashis. Experts confirmed it was a locally advanced case of oral cancer and recommended total glossectomy (removal of the tongue).

Consulting from Iraq
Who: Jakeer Mohammad Sheikh, Iraq
Diagnosis: Prostrate cancer
Jakeer Mohammad Sheikh, 53, a resident of Mosul in Iraq, was diagnosed with prostrate cancer. His local physician advised him to visit Tata Memorial Hospital, but the trip would have cost him over $5,000. Instead, he spent a fraction and applied to Navya. His case was processed and within 24 hours and he was given a treatment plan. He shared the plan with his local physician and was able to proceed with the treatment in his hometown.

South African teen reaches out
Who: Ethan Logan, South Africa
Diagnosis: Ewing's sarcoma
Ethan Logan, a teenager at Durban, South Africa, was undergoing treatment at a private cancer centre for a rare form of cancer - Ewing's sarcoma. His condition had deteriorated despite three lines of chemotherapy over 10 months. The local oncologists were insistent on the expensive Truebeam radiation therapy. His parents approached TMH online and the experts asked to stop it. Instead, they recommended palliative oral metronomic chemotherapy and traditional external beam radiation along with best supportive care.

*As requested by TMC, names of patients have been changed.

Doctors say

Dr CS Pramesh, Coordinator of the National Cancer Grid
'The online expert opinion service is a game changer for regions where the demand for cancer expertise far outstrips the supply'

Gitika Srivastava, Founder of Navya
'We use the patient's medical reports and consult the country's best experts and our databases of medical research'

How it works

Step one:
Submit your medical reports: Please register and then upload scanned copies or images of your medical reports. You can also email your reports to reports@navya.care.

Step two:
Review by experts: Tata's oncologists, who specialise in the patient's type of cancer and in different types of treatments (like surgery, chemotherapy, or radiation therapy) will collectively review and recommend a custom treatment plan.

Step Three:
Collect your report: Collect your expert opinion report from the website or on email and discuss it with family and your treating oncologist before deciding on further treatment.

Rs 6,500
Processing fee for Indian patients

10,779
No. of patients who have used the service

22
No. of countries from which patients have participated

78
Percentage of cases in which doctors follow Tata's treatment plan

48 hrs
Time it takes to process a cancer patient's file online

Rs 6,500
Processing fee for Indian patients

 

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