Virtually the same? Examining the impact of the COVID-19 related shift to virtual lung cancer multidisciplinary team meetings in the UK National Health Service: a mixed methods study

Abstract

ObjectivesTo evaluate the impact of the shift to virtual lung cancer multidisciplinary team meetings (MDTMs) in response to the COVID-19 pandemic, specifically in relation to the magnitude of information technology (IT) issues and distractions and MDT members’/managers’ perceptions and experiences of this shift.DesignA mixed methods study comprising real-time observations of IT issues/distractions within virtual MDTM case discussions held between April and July 2021 and qualitative data from interviews/surveys.SettingEight hospital organisations in Southern England.ParticipantsTeam members (respiratory physicians, surgeons, oncologists, radiologists, pathologists, palliative care professionals, nurses and MDT coordinators) and managers (n=190) across 8 local MDTs.ResultsMDTM observations (n=1664) highlighted significant variation between teams regarding IT functionality. IT issues and other distractions relating to the virtual MDTM format were observed 465 times affecting 20.6% of case discussions, most of which were audio issues (18.1%). Case discussions that had audio issues were, on average, 26 s longer (t(1652)=−2.77, p<0.01). A total of 73 MDT members and managers participated in the survey and 41 participated in interviews, with all 8 teams being represented. Increased flexibility, reduced travel time and easier real-time access to patient information were seen as the main advantages of virtual MDTMs. Views regarding the impact on relational aspects and communication differed. In line with observational findings, concerns were raised in relation to IT, including having inappropriate equipment, insufficient bandwidth (impairing image sharing and video communication) and an overarching theme that virtual meeting platforms provided were not fit for purpose.ConclusionsDespite the potential benefits of virtual MDTMs, IT issues can waste valuable MDTM time. If hospital organisations plan to continue virtual MDTMs, a functioning infrastructure is required, necessitating appropriate resource and investment.

How well does the virtual format of oncology multidisciplinary team meetings work? An assessment of participants’ perspectives and limitations: A scoping review

“…The number of studies at each stage of the screening process is shown in Fig 1 . Study designs of included studies were mostly observational cross-sectional studies (n = 15) [7,[17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Other study designs were retrospective review of records with a cross-sectional survey (n = 12) [5,[31][32][33][34][35][36][37][38][39][40][41], meeting observations with cross-sectional survey (n = 1) [42], mixedmethod design (n = 3) [43][44][45], embedded study design (n = 1) [46], randomized controlled trials (n = 2) [47,48], descriptive qualitative synthesis using free-text cross-sectional surveys (n = 1) [49], and an anthropological analysis (n = 1) [50]. A detailed summary of study characteristics is shown in Table 1.…”

“…One study was published in 1999 [5]. Most studies had populations from VMDTMs based in the United States of America (n = 10) [5,18,21,25,26,33,35,37,38,46], followed by the United Kingdom (n = 8) [7,17,22,23,43,44,47,48]. The distribution of these studies is described in the S5 File.…”

“…Attendance. The foremost benefit of the virtual nature of VMDTMs has been the removed need to schedule rooms for the meeting, thereby facilitating convenient remote access for participants [19,43]. This benefits the meeting itself by impacting clinician attendance as, since the advent of the virtual format, participant attendance in board meetings has reportedly increased [19,43,44].…”

“…The foremost benefit of the virtual nature of VMDTMs has been the removed need to schedule rooms for the meeting, thereby facilitating convenient remote access for participants [19,43]. This benefits the meeting itself by impacting clinician attendance as, since the advent of the virtual format, participant attendance in board meetings has reportedly increased [19,43,44]. However, one study, that assessed responses from a national VMDTM, reported sub-optimal attendance in the national VMDTM owing to irregular meeting times and a lack of resources [49].…”

“…This aspect was deemed time-consuming in two studies [46,49], but was adequate for participants in another study [28]. However, overall VMDTMs possess a considerable time-saving benefit [17,39,43]. In comparison to IMDTMs, Olver et al reported that VMDTMs do not affect physicians' workload [30].…”