Optimization of transmural care by implementation of an online expert panel to assess treatment strategy in patients suffering from colorectal cancer liver metastases: A prospective analysis

Abstract

Introduction Centralization of oncological care results in a growing demand for specialized consultations and referrals. Improved telemedicine solutions are needed to facilitate access to specialist care and select patients eligible for referral. The purpose of this quality improvement initiative was to optimize transmural care for patients suffering from colorectal cancer liver metastases through implementation of an online expert panel. Methods A digital communication platform was developed to share medical data, including high-quality diagnostic imaging of patients suffering from colorectal cancer liver metastases. Feasibility of local treatment strategies was assessed by a panel of liver specialists to select patients for referral. After implementation, an observational cohort study was conducted to evaluate quality improvement in transmural care using revised Standards for Quality Improvement Reporting Excellence guidelines. Results From September 2016–September 2018, eight hospitals were connected to the platform, covering a population of 3 m. In total, 123 cases were assessed, of which 54 (43.9%) were prevented from needless physical referral. Assessment of treatment strategy by an online expert panel significantly reduced the average lead time during multidisciplinary team meetings from 3.73 min to 2.12 min per patient ( p < 0.01). Conclusions Implementation of an online expert panel is an innovative, accessible and user-friendly way to provide cancer-specific expertise to regional hospitals. E-consultation of such panels may result in more efficient multidisciplinary team meetings and prevent fragile patients from needless referral. Sustainability of these panels however is subject to structural financial compensation, so a cost-effectiveness analysis is warranted.

Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

“…A consensus statement for the definition and treatment strategies of oligometastatic oesophagogastric cancer could reduce practice variability, increase the quality of care and offer all patients the optimal treatment approach for oligometastatic disease [31]. The findings of this study (OMEC-2), together with a systematic review on the definition of oligometastatic oesophagogastric cancer (OMEC-1), will be used for a multidisciplinary consensus statement on the definition and treatment of oligometastatic oesophagogastric cancer (OMEC-4).…”

A multidisciplinary neuro-oncological triage panel reduces the time to referral and treatment for patients with a brain tumor

“… 15 Examples of telehealth are online consultation of virtual tumor boards, digital expert panels, and digital triage panels. 16–22 We set out to develop a multidisciplinary neuro-oncological triage panel (NOTP) with standardized digital exchange of patient information and imaging on an online platform to improve the quality of referral in terms of accessibility for referring neurologists and timely referral for patients with neuro-oncological diseases.…”