Digital Tumor Board Solutions Have Significant Impact on Case Preparation

Hammer, Richard; Fowler, Donna; Sheets, Lincoln; Siadimas, Athanasios; Guo, Chaohui; Prime, Matthew

doi:10.1200/cci.20.00029

Cited by 27 publications

(24 citation statements)

References 20 publications

(45 reference statements)

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“…The National Cancer Action Team in England have identified 6 key dimensions for an effective TB including: An appropriate team; reliable infrastructure; well-organized; efficient logistics; patient-centered clinical decision-making; and robust governance. Digital solutions can improve infrastructure, facilitate better TB organization, streamline preparation and conduction [21], enable greater consideration of patient preference, and facilitate evidence-based decisions by integrating additional clinical decision support into the TB workflow. In addition, digital solutions can provide real-time access to data on performance metrics for audit.…”

Section: Challenges Of Tbs Conduction and Opportunity Areas For Technmentioning

confidence: 99%

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A digital tumor board solution impacts case discussion time and postponement of cases in tumor boards

Hammer

Fowler²,

Sheets

et al. 2021

Health Technol.

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Multidisciplinary tumor boards (TBs) is an integral part of cancer care. Emerging evidence shows that effective TB implementation is crucial. It remains largely unknown how digital solutions can assist effective TB conduction. This study aimed to evaluate the impact of a digital solution on case discussion during TB meetings in four cancer types: Breast, Gastrointestinal (GI), Ear, Nose & Throat (ENT), and Hematopathology. A prospective study was performed to evaluate case discussion time during TB meetings pre- and post-solution implementation, at an US academic healthcare cancer center. Data were recorded by a Nurse Navigator for each case during TB meetings. Case discussion times were recorded for 2312 patients, at a total of 286 TB meetings. Significant decreases were observed in the average case discussion time for the breast and GI TBs. We observed a trend for reduction in discussion time variance for all TBs, suggesting the potential of the digital solution to standardize case discussion via provision of uniform case presentation and data access. Postponement rate decreased from 23 to 10% for ENT TB. This study demonstrated that the digital solution enhanced effective TB implementation, with heterogeneity across cancer types.

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Section: Challenges Of Tbs Conduction and Opportunity Areas For Technmentioning

confidence: 99%

“…It assists with coordinating, scheduling, preparing, presenting and documenting decisions for TBs [5,6]. Several recent publications have examined legacy approaches to TBs to identify unmet needs, and demonstrated how NTB could improve efficiency [5,6], by reducing clinician preparation time for TBs [6,20,21].…”

Section: Introductionmentioning

confidence: 99%

A digital tumor board solution impacts case discussion time and postponement of cases in tumor boards

Hammer

Fowler²,

Sheets

et al. 2021

Health Technol.

Self Cite

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“…These results are in line with studies that show digital tools can improve overall preparation, but may be different across multiple users. 5 However, in a pilot study for NAVIFY Tumor Board; 10 both pathologist and radiologist preparation were not affected by a digital preparation tool. The improvement in pathologist preparation we observed may be due to the pathologist in our study using the NAVIFY Tumor Board presentation mode to discuss the DFSP case, as opposed to a different image display tool as the radiologist did.…”

Section: Discussionmentioning

confidence: 99%

“…Some institutions employ nurse navigators that are responsible for collating and bringing together case information for physician review, bringing increased efficiency and better service integration to patient management. 4 , 5 In private and non-academic settings, the primary care provider must bring together all the case information, in addition to any relevant publications or trials that may relate to the case to prepare a presentation for the MDT meeting. MDT meetings are limited by the capacity of the information to be collated and presented well.…”

Section: Introductionmentioning

confidence: 99%

“…Digital MDT tools, such as NAVIFY Tumor Board can support operational details and improve efficiency in MDT preparation. 5 , 10 , 11 With the recent need for virtual connectivity following the covid-19 pandemic, digital engagement has become necessary to bring clinicians together online. Transition of the traditional MDT into a “Smart-MDT” has allowed continuity of care for oncology patients, 12 with clinicians easily adapting to the virtual setting.…”

Section: Introductionmentioning

confidence: 99%

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Virtual Multidisciplinary Review of a Complex Case Using a Digital Clinical Decision Support Tool to Improve Workflow Efficiency

Soo¹,

Jajeh²,

Quah³

et al. 2021

JMDH

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Integration of distinct clinical perspectives in multi-disciplinary tumor board meetings is critical to determine optimal patient care. Digital tools can support the data consolidation needed for meeting preparation and data sharing during complex case reviews. In this paper, we assessed the value of a clinical decision support tool on workflow efficiency and conducting a complex case review of a dermatofibrosarcoma protuberans (DFSP) tumor. Methods: Case presentation was performed by each unique clinical specialty that had relevant information about the patient; an oncologist, a pathologist, and a radiologist. Virtual discussion was completed online with case presentation and documentation with NAVIFY Tumor Board. Workflow efficiency assessment was done through interviews and observation of the # of steps across different team members involved in preparing and conducting cancer multidisciplinary team (MDT) meetings before and after the implementation of the NAVIFY Tumor Board solution. Results: Case review consisted of surgical and therapeutic intervention history, distinct histological and sequencing patterns representative of DFSP, with radiological review to determine areas for surgical intervention. Consolidation of clinical input led to a recommendation of a formal external hemipelvectomy with potential chemotherapy. Workflow assessment demonstrated a 46% total reduction in the # of steps for meeting preparation (from 69 to 37), with specific changes based on role: data manager (33 to 15), pathologist (26 to 13), radiologist (no change), and logistics (5 to 4). There was a 31% total reduction in the # of steps for conducting the meeting (from 51 to 35). Conclusion: Utilizing a digital clinical decision support tool helped to consolidate patient data and improved case presentation through workflow efficiency. This allowed for improved interdisciplinary discussion on a complex DFSP case and supported the determination of a clinical decision.

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Association of Parental Status and Gender With Burden of Multidisciplinary Tumor Boards Among Oncology Physicians

Chau,

LaGuardia,

Kim

et al. 2023

JAMA Netw Open

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ImportanceTumor boards are integral to the care of patients with cancer. However, data investigating the burden of tumor boards on physicians are limited.ObjectiveTo investigate what physician-related and tumor board–related factors are associated with higher tumor board burden among oncology physicians.Design, Setting, and ParticipantsTumor board burden was assessed by a cross-sectional convenience survey posted on social media and by email to Cedars-Sinai Medical Center cancer physicians between March 3 and April 3, 2022. Tumor board start times were independently collected by email from 22 top cancer centers.Main Outcomes and MeasuresTumor board burden was measured on a 4-point scale (1, not at all burdensome; 2, slightly burdensome; 3, moderately burdensome; and 4, very burdensome). Univariable and multivariable probabilistic index (PI) models were performed.ResultsSurveys were completed by 111 physicians (median age, 42 years [IQR, 36-50 years]; 58 women [52.3%]; 60 non-Hispanic White [54.1%]). On multivariable analysis, factors associated with higher probability of tumor board burden included radiology or pathology specialty (PI, 0.68; 95% CI, 0.54-0.79; P = .02), attending 3 or more hours per week of tumor boards (PI, 0.68; 95% CI, 0.58-0.76; P &lt; .001), and having 2 or more children (PI, 0.65; 95% CI, 0.52-0.77; P = .03). Early or late tumor boards (before 8 am or at 5 pm or after) were considered very burdensome by 33 respondents (29.7%). Parents frequently reported a negative burden on childcare (43 of 77 [55.8%]) and family dynamics (49 of 77 [63.6%]). On multivariable analysis, a higher level of burden from early or late tumor boards was independently associated with identifying as a woman (PI, 0.69; 95% CI, 0.57-0.78; P = .003) and having children (PI, 0.75; 95% CI, 0.62-0.84; P &lt; .001). Independent assessment of 358 tumor boards from 22 institutions revealed the most common start time was before 8 am (88 [24.6%]).Conclusions and RelevanceThis survey study of tumor board burden suggests that identifying as a woman or parent was independently associated with a higher level of burden from early or late tumor boards. The burden of early or late tumor boards on childcare and family dynamics was commonly reported by parents. Having 2 or more children, attending 3 or more hours per week of tumor boards, and radiology or pathology specialty were associated with a significantly higher tumor board burden overall. Future strategies should aim to decrease the disparate burden on parents and women.

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Digital Tumor Board Solutions Have Significant Impact on Case Preparation

Cited by 27 publications

References 20 publications

A digital tumor board solution impacts case discussion time and postponement of cases in tumor boards

A digital tumor board solution impacts case discussion time and postponement of cases in tumor boards

Virtual Multidisciplinary Review of a Complex Case Using a Digital Clinical Decision Support Tool to Improve Workflow Efficiency

Association of Parental Status and Gender With Burden of Multidisciplinary Tumor Boards Among Oncology Physicians

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