After her March 2018 cancer diagnosis, Cami Evans was receiving treatment near her home in Atwater, in California's Central Valley. But her oncologist wasn't very knowledgeable about her type of cancer, sarcoma, which can spring up in various parts of the body.
She had heard about Kristen Ganjoo, MD, who specializes in treating sarcoma, and wanted to see her. But she lacked a referral or any personal connections to Ganjoo, so she typed "second opinion Stanford" into an internet search engine.
Up popped the Stanford Medicine Online Second Opinion program. Launched Nov. 1, 2018, the program allows people anywhere in the world, for a fee, to have their medical records reviewed by a Stanford physician who will make recommendations for care.
Evans, 41, provided her information and paid the fee. In about a month she heard from Ganjoo, who recommended that Evans continue with the chemotherapy she was receiving but also receive a scan to ensure it was working. She had several other recommendations, including a medication to prevent heart failure.
"Just reading through her report, I felt she was more versed in my options and in providing care," Evans said. "I felt so much more comfortable working with her."
Patients have always sought second opinions at Stanford, said Leslie Haas, digital strategy manager for Stanford Health Care. But before the Second Opinion program, they needed to do so through informal channels. If they had a personal connection to a physician at Stanford, they might contact him or her. Or they'd simply make an appointment.
"For people far away, the program is a lot cheaper and more convenient than traveling here," Haas said. "It lets people around the globe receive assistance from a Stanford physician."
For some patients who use the Second Opinion program, the information they receive provides peace of mind: The Stanford specialist confirms that the care they're receiving is appropriate.
Other patients are able to incorporate the suggestions into their care plan. Still others choose to visit the doctor who provided the second opinion -- about a quarter of the Second Opinion users have become regular patients at Stanford, Haas said. More than 2,000 have used the program since it launched.
To enroll in the program, patients create an account online. If their medical records are in the United States, all they need to do is provide the names and locations of physicians who have provided care. They can upload medical records if they have them on hand -- doing so will help Stanford physicians reply more quickly. If the medical records are outside the United States, they will need to send them to Stanford. A Stanford physician with the appropriate expertise will then review the patient's record and respond with written recommendations in about two weeks.
Both physicians and patients are pleased with the program, Haas said. "Patients appreciate that we have expedited the process of receiving a second opinion. And physicians like receiving patient information in an organized, streamlined way."
When Evans received Ganjoo's recommendations, she brought them to her oncologist, who followed what he could of her treatment plan. Once Evans was able to switch her insurance to cover Stanford Health Care, she scheduled an appointment with Ganjoo, an associate professor of oncology at the School of Medicine.
The Second Opinion program "made the transition to becoming her patient so much smoother," Evans said. "It kept me from having to go through the whole process of becoming a patient, going through all the back history. They could just take everything I already had and work with that."
Ganjoo said that the Second Opinion program is especially helpful for patients with rare conditions such as sarcomas. Oncologists in smaller organizations may encounter only two or three a year, she said, and they're usually glad to receive advice from experts who treat the condition more frequently.
"It's a great program," Ganjoo said. "The information is so organized, it takes me an hour to develop an opinion. I can just click a button and send a message to the patient, or to their oncologist."
In June, Evans underwent surgery at Stanford Hospital to remove tumors from her liver. Afterward, as she was recovering in the hospital, she received visits from a harpist, a massage therapist and a support dog -- all of whom eased her stress and helped her heal.
"The surgery was very successful," said Evans, who continues to see Ganjoo for her cancer treatment. "It's been a huge blessing to have been able to work with the doctors and surgeons at Stanford. I'm just really grateful for the program."
This article originally appeared in the Stanford Medicine Newsletter.
For adult patients: Enroll in the Second Opinion program here. Currently, specialists in cardiovascular services, oncology, orthopedics, neurology, neurosurgery and ear, nose and throat are available to provide second opinions.
For pediatric patients: Enroll in the program here. Specialists in orthopedics and sports medicine, brain tumors, epilepsy, neurosurgery, heart transplant and heart failure, ear, nose and throat and cardiothoracic surgery are available to provide second opinions.
More pediatric and adult specialties are expected to be available soon.
Photo of Cami Evans, with her children, Peyton and Alexa Johnson, by Steve Fisch