Implementation and evaluation of video-based tumor board conferencing in Haiti.

Abstract

e18333 Background: Lack of local oncology specialists remains a challenge in delivering cancer care in low-resource areas. Since 2013, Dana-Farber Cancer Institute has partnered with Zanmi Lasante, a Haitian non-profit to support the oncology department at University Hospital Mirebalais, a tertiary government hospital. In an effort to build local capacity, the partnership established weekly remote tumor boards between US oncologists and Haitian clinicians. For five years, the tumor boards were conducted by phone; they were limited by inconsistent participant engagement and suboptimal sound quality. The goal of the project was to enhance the tumor boards by implementing a video-based system, and to evaluate its feasibility and acceptance. Methods: We conducted a baseline mixed-methods assessment of satisfaction among tumor board participants. We trained participants on the new video-platform (ZOOM) and implemented its use. We conducted weekly surveys over an 18-week period, using a Likert 1-5 scale to assess call quality and satisfaction with discussion. We collected general information about cases and call logistics. Lastly, we conducted a post-implementation survey. Two-sample T-test was used to examine changes in satisfaction scores. Results: Over the study period, 12 calls occurred; six calls were cancelled –due holidays (2), lack of cases (4). A total of 32 cases were presented, an average of 2.67/call. The cases by cancer type were: 75% breast, 9.38% gynecologic, 9.38%, hematologic, and 6.26% others. Baseline overall satisfaction ranking from 11 participants (response rate-RR 78.6%) was 3.18, while post-implementation from 8 participants (RR 66.7%) was 4.24, P-value= 0.0025. Summary of Weekly Calls (Averages). Conclusions: There was improved call quality and overall satisfaction with transitioning to video-based tumor boards. During longer video calls with didactics, Haiti participants noted lower call quality and satisfaction, likely due to low internet-bandwidth. Videoconference tumor boards are feasible in low resource settings.[Table: see text]