Utilization of a Virtual Tumor Board for the Care of Patients With Renal Masses: Experience From a Quality Improvement Collaborative

Abstract

Introduction: Multidisciplinary tumor board meetings are useful sources of insight and collaboration when establishing treatment approaches for oncologic cases. However, such meetings can be time intensive and inconvenient. We implemented a virtual tumor board within the Michigan Urological Surgery Improvement Collaborative to discuss and improve the management of complicated renal masses.Methods: Urologists were invited to discuss decision-making for renal masses through voluntary engagement. Communication was performed exclusively through email. Case details were collected and responses were tabulated. All participants were surveyed about their perceptions of the virtual tumor board.Results: Fifty renal mass cases were reviewed in a virtual tumor board that included 53 urologists. Patients ranged from 20-90 years old and 94% had localized renal mass. The cases generated 355 messages, ranging from 2-16 (median 7) per case; 144 responses (40.6%) were sent via smartphone. All urologists (100%) who submitted to the virtual tumor board had their questions answered. The virtual tumor board provided suggestions to those with no stated treatment plan in 42% of cases, confirmed the physician's initial approach to their case in 36%, and offered alternative approaches in 16% of cases. Eighty-three percent of survey respondents felt the experience was "Beneficial" or "Very Beneficial," and 93% stated increased confidence in their case management.

Editorial Commentary

“…2 The current article comes from one of the most laudable statewide quality improvements initiatives in the urology field, the well-known “MUSIC” (for Michigan Urological Surgery Improvement Collaborative) group. 3 In this study, the authors showed the impact of implementing a virtual tumor board (VTB) for the discussion of how to best tackle cases of renal masses. It is interesting to see that in a nonnegligible proportion of cases the initial management plan was changed and, for example, a conservative management was endorsed over a surgical intervention.…”

Editorial Commentary

“…Hijazi et al introduced a virtual tumor board (VTB) format to improve complex renal mass care throughout Michigan. 1 The group utilized an asynchronous email format, recruiting physicians from within MUSIC (Michigan Urological Surgery Improvement Collaborative). After 50 cases, the VTB helped generate treatment plans in 42% of cases and shifted management decisions in another 16%.…”