Development of a virtual multidisciplinary lung cancer tumor board in a community setting.

Abstract

Purpose: Creating an effective platform for multidisciplinary tumor conferences can be challenging in the rural community setting. The Duke Cancer Network created an Internet-based platform for a multidisciplinary conference to enhance the care of patients with lung cancer. This conference incorporates providers from different physical locations within a rural community and affiliated providers from a university-based cancer center 2 hours away. An electronic Web conferencing tool connects providers aurally and visually.Methods: Conferences were set up using a commercially available Web conferencing platform. The video platform provides a secure Web site coupled with a secure teleconference platform to ensure patient confidentiality. Multiple disciplines are invited to participate, including radiology, radiation oncology, thoracic surgery, pathology, and medical oncology. Participants only need telephone access and Internet connection to participate. Results: Patient histories and physicals are presented, and theWeb conferencing platform allows radiologic and histologic images to be reviewed. Treatment plans for patients are discussed, allowing providers to coordinate care among the different subspecialties. Patients who need referral to the affiliated universitybased cancer center for specialized services are identified. Pertinent treatment guidelines and journal articles are reviewed. On average, there are 10 participants with one to two cases presented per session. Conclusion:The use of a Web conferencing platform allows subspecialty providers throughout the community and hours away to discuss lung cancer patient cases. This platform increases convenience for providers, eliminating travel to a central location. Coordination of care for patients requiring multidisciplinary care is facilitated, shortening evaluation time before definitive treatment plan.

Establishment of a Regional Virtual Tumor Board Program to Improve the Process of Care for Patients With Hepatocellular Carcinoma

“…15,16 We previously developed a regional VTB program within the Department of Veterans Affairs (VA) health care system to meet the specialized oncology needs of patients with cancer treated at distant sites and reported favorable results after the pilot phase of implementation. 15,17 The purpose of this study was to evaluate the impact of a regional VTB program on the process of care for HCC by examining the MDE process for patients referred to specialized care from distant VA facilities.…”

Innovating the outreach of comprehensive cancer centers

“…In a complementary approach, at least in Germany, patients are increasingly presented to tumor boards at the CCC by external treating physicians (Brandts, ). Because physical attendance is not always possible, virtual attendance by video‐conferencing of doctors from surrounding hospitals or practices has been effective to increase the number of patients discussed in a multidisciplinary setting throughout the region (Stevenson et al, ). Video‐conferencing is of particular importance for CCCs in rural settings by eliminating travel and shortening evaluation time before treatment (Stevenson et al, ).…”

Measuring the quality of multi-disciplinary thoracic oncology care

“…The advent of immunotherapy, improvements in radiation techniques, and developments in the safety and efficacy of surgery have thrown into question traditional treatment paradigms and created many areas of uncertainty. Virtual tumor boards may aid in extending the benefits of multidisciplinary care for these situations to patients in remote areas (14), while "mini tumor boards" have been proposed for patients in low-and middle-income countries (10). Clearly, patient-centered outcomes such as quality of life and satisfaction are an area in need of greater attention and research, and what impact multidisciplinary care has on these important measures of healthcare efficiency and efficacy must be investigated.…”