BOSTON (CBS) — While most of the world has adapted to “virtual” medicine during the pandemic, it is nothing new for some patients at Brigham and Women’s Hospital and Dana-Farber Cancer Institute.
Rich Boyajian, a nurse practitioner in Radiation Oncology at Brigham & Women’s Hospital, is the founder of the Virtual Prostate Cancer Clinic.
Nearly a decade ago, when he realized how far patients were traveling for routine tests and how busy the doctors were going over the test results.
“There has to be a better way,” he thought.
With a grant from Brigham and Women’s Hospital, Boyajian created the program and the software.
When the virtual clinic opened in 2016, David Fraley was among the first patients to enroll. He realized the convenience and efficiency immediately.
Fraley, who was treated for prostate cancer in 2011, no longer had to drive all the way into Boston for lab work. He could do it in Foxboro.
“You don’t have to waste three or four hours out of the day coming into Boston. And if there is a situation, you deal with it,” Fraley said.
Boyajian and his colleague, Physician Assistant Ashley Kowtoniuk, use a zip code search to identify affiliated labs that a patient can easily visit.
Once the patient’s blood work (for PSA tests) and the patient’s questionnaire are in, the software automatically extracts the information and “knows” if the patient has relapsed.
It can also tell if the patient has significant symptoms.
Boyajian and Kowtoniuk can access the information from their computer, wherever they are, contact the patient, and set up the follow-up visit with a doctor.
The clinic’s ability to keep patients on their follow-up schedules without interruption was particularly helpful during the pandemic.
“It’s software doing the job of helping us triage patients. We’re sitting at a computer. We can do our work from home. My daughters would tell you that they have video of me taking care of patients from Disneyworld. It allows you the flexibility to practice wherever you are,” Boyajian said.
Patients enjoy the same flexibility. The clinic serves patients in Kazakhstan, the UAE and Bermuda, in addition to all the New England states and Florida.
“Patients don’t want to leave the Dana Farber-Brigham and Women’s Center,” Boyajian said. “They feel like the doctors have saved their lives and they want to stay attached to them as long as they can.”
Boyajian understands that feeling well.
25 years ago, he was a leukemia patient at DFCI who received a life-saving bone marrow transplant. His connection to the patients and doctors in the virtual clinic is personal.
He’s now hoping that virtual clinics can become a fixture in patient care for other diseases, including other cancers.
“We want to show other radiation oncologists that this is something you could utilize. It’s not brain surgery, just basically shifting the care model so that we can treat more patients. We have the best doctors in the world around here. And if we can allow them to see more of these patients, then we’ve done our job.”
David Fraley is getting ready to ride his 13th Pan-Mass Challenge. He splits his time between Rhode Island and Wisconsin, where he can spend time with his granddaughter. He didn’t miss a single lab test during the pandemic and applauds Boyajian for a clinic that has allowed him to remain connected with his doctors in Massachusetts.
“Rich was way ahead of his time,” he said.
Asked if the virtual clinic has detected any “red flags”, Boyajian nodded.
“There have. My PSA went over the magic 2.0 level. I just had a PET scan and a prostate MRI in the past month. They’re being very cautious. It’s a clean scan for right now.”
That, Boyajian explains, is exactly how the clinic is supposed to work. If Fraley needs immediate attention, he will be able to get it.
“Our access to care has grown by 20% a year on average. We’re treating more patients with prostate cancer that we were before the clinic existed.”
Boyajian, a six-year PMC rider expects to be back on the bike (and in the ride) in 2022.
“I’ve skipped a few years,” he explains smiling, “David’s definitely outdone me. Next year, I’ll be back pedaling again.”