Virtual multidisciplinary team meetings in the age of COVID-19: an effective and pragmatic alternative

Abstract

The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and the associated coronavirus disease 2019 have had a profound global and individual burden, with 1,610,909 confirmed cases and 99,690 confirmed deaths across 213 countries, areas, and territories at the time of writing (1).The highly transmissible nature of the novel coronavirus, its potential for asymptomatic transmission, and the lack of a curative treatment, has necessitated the enforcement of stringent social distancing and quarantine measures in order to limit the rate of infection-thereby reducing morbidity and mortality whilst also reducing the strain on rapidly saturating healthcare systems (2).Recent literature has identified that medical professionals account for COVID-19 patients due to their increased and repeated exposure to the virus (3). This unhappy truth, combined with a lack of testing and personal protective equipment for key workers, has, in some areas, seen a diminishment of the workforce and a reduction of our ability to combat the disease on both a local and international level (4).Multidisciplinary team meetings (MDTs) are defined by the United Kingdom's National Health Service as 'a group of professionals from one or more clinical disciplines who together make decisions regarding recommended treatment of individual patients' (5). They have become the clinical mainstay and gold-standard for the care of complex patients, in particular those with oncological malignancies. As such, their efficacy and cost-effectiveness is well documented in the literature (6)(7)(8).In this light, as MDTs in their current format necessitate face-to-face contact between multiple clinical teams, they have the potential to act as potent accelerators of viral transmission. This article evaluates the efficacy of virtual MDTs in the light of the SARS-CoV-2 pandemic as a means of reviewing patient care at a physical distance, thereby maintaining the safety of clinicians by minimizing the risk of infection.We conducted a survey of 50 practicing physicians who have been using virtual MDTs since mid-March of the SARS-CoV-2 pandemic (1 month at the time of writing). This evaluated their thoughts on whether or not virtual MDTs are a safe alternative to in-person MDTs and on how the shift to a virtual space may have affected the standard of patient care. This was achieved through comparison of opinions of virtual MDTs to in-person MDTs across eleven core criteria: accessibility; clinical decision process and consensus; clinical governance; communication; continuity

Will virtual multidisciplinary team meetings become the norm for musculoskeletal oncology care following the COVID-19 pandemic? - experience from a tertiary sarcoma centre

“…This factor helped in building stronger relationships, better team working and encouraged more robust conversations. This result was similar to the findings in a survey among participants of an MDT where virtual platforms had been implemented, in which 42% participants preferred ‘face-to-face’ MDTs for the same reasons [ 25 ].…”

“…Two other key factors, ‘change in treatment plan’ and ‘decision making to achieve diagnosis’ also was found to be unaffected compared to face-to-face MDTs, as reported by the majority of the participants. A survey among participants who had been in virtual meetings involving head and neck cancers showed that 91.7% of them felt good access to patient data and adequate discussion over virtual platforms [ 25 ].…”

Will Virtual Multidisciplinary Team Meetings Become the Norm for Musculoskeletal Oncology Care following the COVID-19 Pandemic? - Experience from a tertiary sarcoma centre

“…This factor helped in building stronger relationships, better team working and encouraged more robust conversations. This result was similar to the ndings in a survey among participants of an MDT where virtual platforms had been implemented, in which 42% participants preferred 'face-to-face' MDTs for the same reasons 23 .…”

“…Two other key factors, 'change in treatment plan' and 'decision making to achieve diagnosis' also was found to be unaffected compared to face-to-face MDTs, as reported by the majority of the participants. A survey among participants who had been in virtual meetings involving head and neck cancers showed that 91.7% of them felt good access to patient data and adequate discussion over virtual platforms 23 .…”

The Role of Telehealth During the COVID-19 Pandemic Across the Interdisciplinary Cancer Team: Implications for Practice

“…Many cancer centres have gone onto virtual cancer multidisciplinary team (MDT) meetings using various platforms including Microsoft Teams to ensure socially distant meetings. 39 This pragmatic approach has been welcomed by all health disciplines to ensure that multidisciplinary cancer team discussions continue to occur in a timely and safe approach during the COVID-19 pandemic 40 This platform has allowed specialized clinicians and teams to access meetings remotely, having a presence in meetings they may not have had access to prior to the pandemic, providing high quality advice to teams and care to patients. It is important for healthcare organisations to ensure that such platforms are safe and secure in keeping with data protection legislation.…”