Executive SummaryMultidisciplinary tumor boards involve various providers (e.g., oncology physicians, nurses) in patient care. Although many Community Hospitals have local tumor boards that review all types of cases, many providers, particularly in rural areas and smaller institutions, still lack access to tumor boards specializing in a particular type of cancer (e.g., breast, gastrointestinal, hematologic). Videoconferencing technology can connect providers across geographic locations and institutions; however, virtual tumor board (VTB) programs using this technology are uncommon.In this study, we evaluated the feasibility of a new VTB program at UNC Lineberger Comprehensive Cancer Center, which connects community-based clinicians to UNC tumor boards. We used an embedded case study design with UNC VTB as the overarching case, comprised of multiple tumor boards representing different cancer types, each with individual clinician participants (our primary unit of analysis). Methods included observations, interviews, and surveys. § Corresponding Author: 135 Dauer Dr., CB # 7411, Department of Health Policy and Management, UNC Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7411, chris_shea@unc.edu, Phone: 919-966-1938, Fax: 919-966-6961.
COMPETING INTERESTSThe authors report no competing interests.The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or AHRQ.
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NIH-PA Author ManuscriptOur findings suggest that participants were generally satisfied with the VTB. Cases presented at VTB were appropriate, sufficient information was available for discussion, and technology problems were not common. UNC clinicians viewed the VTB as a service to patients and colleagues and an opportunity for clinical trial recruitment. Community-based clinicians presenting at VTB valued the discussion, even if it simply confirmed their original treatment plan or did not yield consensus recommendations. However, barriers to participation for communitybased clinicians included timing of the VTB and lack of reimbursement. To maximize benefits of the VTB, barriers to participation should be addressed, scheduling and preparation processes optimized, and appropriate measures for evaluating impact identified.
Keywordsvideoconferencing; health services accessibility; oncology service; hospital; interdisciplinary communication; patient care management
BACKGROUNDMany health care systems across the world have adopted a multidisciplinary approach to cancer care. This approach, intended to facilitate communication between care providers by effectively using information (e.g., research findings) to improve quality and continuity of care, is important given the increasing complexity of managing cancer patients (Taylor et al., 2010). One venue for this approach is a multidisciplinary tumor board (or multidisciplinary cancer conference), where clinicians presen...