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Arafat W, Fu P, Wagner AJ, Osterman T, Martin DB, Sugalski J, Heinrichs T, Racz J, Tevaarwerk AJ. Clinician Perspectives Regarding the Impact of Information Technology on Multidisciplinary Tumor Boards: A National Comprehensive Cancer Network Survey. JCO Clin Cancer Inform 2023; 7:e2300056. [PMID: 37944060 DOI: 10.1200/cci.23.00056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/10/2023] [Accepted: 09/22/2023] [Indexed: 11/12/2023] Open
Abstract
PURPOSE Multidisciplinary tumor boards (MTBs) support high-quality cancer care. Little is known about the impact of information technology (IT) tools on the operational and technical aspects of MTBs. The National Comprehensive Cancer Network EHR Oncology Advisory Group formed a workgroup to investigate the impact of IT tools such as EHRs and virtual conferencing on MTBs. METHODS The workgroup created a cross-sectional survey for oncology clinicians (eg, pathology, medical, surgical, radiation, etc) participating in MTBs at 31 National Comprehensive Cancer Network member institutions. A standard invitation e-mail was shared with each EHR Advisory Group Member with a hyperlink to the survey, and each member distributed the survey to MTB participants at their institution or identified the appropriate person at their institution to do so. The survey was open from February 26, 2022, to April 26, 2022. Descriptive statistics were applied in the analysis of responses, and a qualitative thematic analysis of open-ended responses was completed. RESULTS Individuals from 27 institutions participated. Almost all respondents (99%, n = 764 of 767) indicated that their MTBs had participants attending virtually. Most indicated increased attendance (69%, n = 514 of 741) after virtualization with the same or improved quality of discussion (75%, n = 557 of 741) compared with in-person MTBs. Several gaps between the current and ideal state emerged regarding EHR integration: 57% (n = 433 of 758) of respondents noted the importance of adding patients for MTB presentation via the EHR, but only 40% (n = 302 of 747) reported being able to do so most of the time. Similarly, 87% (n = 661 of 760) indicated the importance of documenting recommendations in the EHR, but only 53% (n = 394 of 746) reported this occurring routinely. CONCLUSION Major gaps include the lack of EHR integration for MTBs. Clinical workflows and EHR functionalities could be improved to further optimize EHRs for MTB management and documentation.
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Affiliation(s)
- Waddah Arafat
- Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
| | - Paul Fu
- City of Hope National Medical Center, Duarte, CA
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Gebbia V, Guarini A, Piazza D, Bertani A, Spada M, Verderame F, Sergi C, Potenza E, Fazio I, Blasi L, La Sala A, Mortillaro G, Roz E, Marchese R, Chiarenza M, Soto-Parra H, Valerio MR, Agneta G, Amato C, Lipari H, Baldari S, Ferraù F, Di Grazia A, Mancuso G, Rizzo S, Firenze A. Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer. Pulm Ther 2021; 7:295-308. [PMID: 34089169 PMCID: PMC8177259 DOI: 10.1007/s41030-021-00163-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/20/2021] [Indexed: 01/31/2023] Open
Abstract
To date, the virtual multidisciplinary tumor boards (vMTBs) are increasingly used to achieve high-quality treatment recommendations across health-care regions, which expands and develops the local MTB team to a regional or national expert network. This review describes the process of lung cancer-specific MTBs and the transition process from face-to-face tumor boards to virtual ones. The review also focuses on the project organization's description, advantages, and disadvantages. Semi-structured interviews identified five major themes for MTBs: current practice, attitudes, enablers, barriers, and benefits for the MTB. MTB teams exhibited positive responses to modeled data feedback. Virtualization reduces time spent for travel, allowing easier and timely patient discussions. This process requires a secure web platform to assure the respect of patients' privacy and presents the same unanswered problems. The implementation of vMTB also permits the implementation of networks especially in areas with geographical barriers facilitating interaction between large referral cancer centers and tertiary or community hospitals as well as easier access to clinical trial opportunities. Studies aimed to improve preparations, structure, and conduct of MTBs, research methods to monitor their performance, teamwork, and outcomes are also outlined in this article. Analysis of literature shows that MTB participants discuss 5-8 cases per meeting and that the use of a vMTB for lung cancer and in particular stage III NSCLC and complex stage IV cases is widely accepted by most health professionals. Despite still-existing gaps, overall vMTB represents a unique opportunity to optimize patient management in a patient-centered approach.
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Affiliation(s)
- Vittorio Gebbia
- Medical Oncology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, La Maddalena Clinic for Cancer, University of Palermo, Via San Lorenzo Colli n. 312D, 90100, Palermo, Italy.
- GSTU Foundation, Palermo, Italy.
| | - Aurelia Guarini
- Medical Oncology Unit, Fondazione Ospedale Giglio, Cefalù, Palermo, Italy
| | | | - Alessandro Bertani
- Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS Ismett, UPMC, Palermo, Italy
| | - Massimiliano Spada
- Medical Oncology Unit, Fondazione Ospedale Giglio, Cefalù, Palermo, Italy
| | | | - Concetta Sergi
- Thoracic Surgery Unit, ARNAS, Ospedale Garibaldi, Nesima, Catania, Italy
| | - Enrico Potenza
- Thoracic Surgery Unit, ARNAS, Ospedale Garibaldi, Nesima, Catania, Italy
| | - Ivan Fazio
- Radiation Therapy Unit, Clinica Macchiarella, Palermo, Italy
| | - Livio Blasi
- Medical Oncology Unit, Arnas Civico, Palermo, Italy
| | - Alba La Sala
- Bronchial Endoscopy Unit, Arnas Civico, Palermo, Italy
| | | | - Elena Roz
- Pathology Unit, La Maddalena Clinic for Cancer, Palermo, Italy
| | - Roberto Marchese
- Thoracic Surgery Unit, La Maddalena Clinic for Cancer, Palermo, Italy
| | | | | | | | - Giuseppe Agneta
- Thoracic Surgery Unit, Ospedale Cervello Villa Sofia, Palermo, Italy
| | - Carmela Amato
- Patients Advocacy "Serena a Palermo", Palermo, Italy
| | - Helga Lipari
- Medical Oncology Unit, Ospedale Cannizzaro, Catania, Italy
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University Hospital G. Martino, Messina, Italy
| | - Francesco Ferraù
- Medical Oncology Unit, Ospedale San Vincenzo, Taormina, Messina, Italy
| | - Alfio Di Grazia
- Radiation Oncology Unit, Istituto Clinico Humanitas, Catania, Italy
| | - Gianfranco Mancuso
- Medical Oncology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, La Maddalena Clinic for Cancer, University of Palermo, Via San Lorenzo Colli n. 312D, 90100, Palermo, Italy
| | - Sergio Rizzo
- Medical Oncology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, La Maddalena Clinic for Cancer, University of Palermo, Via San Lorenzo Colli n. 312D, 90100, Palermo, Italy
| | - Alberto Firenze
- Risk Management Unit, Policlinico, University of Palermo, Palermo, Italy
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Chakravarthy VB, Grabowski MM, Benzel EC, Benzil DL. Neuro-Oncology Practice resources for optimizing care and practice in spinal oncology. Neurooncol Pract 2020; 7:i62-i69. [PMID: 33299575 DOI: 10.1093/nop/npaa050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
As the diagnosis and treatment of systemic cancers continues to improve, increased patient survival has resulted in a rise in the number of patients who develop spinal metastases (SM). Within many areas of oncology, utilization of multidisciplinary care models in the management and decision making of SM patients has proven effective for optimizing care and improving patient safety. Three main goals of an effective clinical pathway include improving outcomes and quality, improving the patient experience, and lowering cost. This paper outlines the strategies employed to optimally establish such a collaborative program for the management of patients with SM, as well as direct providers in and out of the field, patients and caregivers, and practice managers to the appropriate resources.
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Affiliation(s)
- Vikram B Chakravarthy
- Department of Neurosurgery, Cleveland Clinic of Case Western Reserve School of Medicine, Cleveland, Ohio
| | - Matthew M Grabowski
- Department of Neurosurgery, Cleveland Clinic of Case Western Reserve School of Medicine, Cleveland, Ohio
| | - Edward C Benzel
- Department of Neurosurgery, Cleveland Clinic of Case Western Reserve School of Medicine, Cleveland, Ohio
| | - Deborah L Benzil
- Department of Neurosurgery, Cleveland Clinic of Case Western Reserve School of Medicine, Cleveland, Ohio
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Dharmarajan H, Anderson JL, Kim S, Sridharan S, Duvvuri U, Ferris RL, Solari MG, Clump DA, Skinner HD, Ohr JP, Zandberg DP, Branstetter B, Hughes MA, Traylor KS, Seethala R, Chiosea SI, Nilsen ML, Johnson JT, Kubik MW. Transition to a virtual multidisciplinary tumor board during the COVID-19 pandemic: University of Pittsburgh experience. Head Neck 2020; 42:1310-1316. [PMID: 32329958 PMCID: PMC7264555 DOI: 10.1002/hed.26195] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 11/06/2022] Open
Abstract
Multidisciplinary conferences (MDC) are an important component of head and neck oncologic care including diagnosis, treatment, and survivorship. Virtual MDC allows for improved collaboration between providers at distant sites and proper allocation of health care resources in a time of crisis. When approached systematically, a virtual MDC is feasible to design and implement in a large academic medical center with multiple satellite hospitals.
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Affiliation(s)
- Harish Dharmarajan
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jennifer L Anderson
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Seungwon Kim
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Shaum Sridharan
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Umamaheswar Duvvuri
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Robert L Ferris
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mario G Solari
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - David A Clump
- Department of Radiation Oncology, University of Pittsburgh Medical Center-Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - Heath D Skinner
- Department of Radiation Oncology, University of Pittsburgh Medical Center-Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - James P Ohr
- Department of Medical Oncology, University of Pittsburgh Medical Center-Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - Dan P Zandberg
- Department of Medical Oncology, University of Pittsburgh Medical Center-Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - Barton Branstetter
- Department of Radiology, Division of Neuroradiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Marion A Hughes
- Department of Radiology, Division of Neuroradiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Katie S Traylor
- Department of Radiology, Division of Neuroradiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Raja Seethala
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Simion I Chiosea
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Marci L Nilsen
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jonas T Johnson
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mark W Kubik
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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