Multidisciplinary tumor boards are important for the continuity of care and improved patient outcomes. “Cancer care teams devote considerable time and resources to tumor boards,” says Benjamin Sintay, chief physicist, Cone Health, Greensboro, North Carolina. “It’s important to measure the value of tumor boards so we can maximize their benefit for patients.” Maximizing the effectiveness of tumor boards is one reason Cone Health is implementing the Multidisciplinary Tumor Board module of the Varian 360 Oncology™ care management platform. The other is improving the value equation by making resource-intensive tumor boards more productive and efficient.
Cone Health is a private, not-for-profit community-based health system of six hospitals and hundreds of locations in central North Carolina. “It’s our goal to be in the top 10 percent of all organizations in providing value to patients,” says Sintay. “In radiation oncology specifically, we have a vision of being a national leader in providing innovative solutions in patient value.” In keeping with that vision, Cone Health is first implementing Multidisciplinary Tumor Board at its brain tumor clinic, one of six clinics devoted to cancer care.
The obstacles to running a productive brain tumor board mirror many of the obstacles that stand in the way of improving cancer care in general.
- The complexities of integrating data from multiple sources across the care spectrum.
- The challenges of analyzing the data and using it for evidence-based decisions.
- The burden of time-consuming manual processes that are also vulnerable to error or oversight.
- The limitations of technology that make information access and multidisciplinary collaboration difficult.
These are the obstacles that 360 Oncology is designed to overcome. 360 Oncology care management is a cloud-based platform that brings together radiation, medical and surgical oncology, social services, primary care physicians, as well as the patient, to facilitate true collaborative and coordinated care. It also includes access to rapid, real-time learning systems that may help cancer teams transform clinical evidence into clinical practice. The web-based multidisciplinary tumor board module integrates the relevant patient records, lab reports, diagnostic images, and team recordkeeping tools to facilitate collaborative case review and decision-making.
Cone Health’s brain tumor clinic is a high functioning group of medical professionals comprising radiation oncologists, neurosurgeons, pathologists, neuro-radiologists, medical oncologists, and others, all with important roles in serving patients. They meet weekly to discuss as many as 15 patients. “When we take time to have a multidisciplinary discussion, we want it to be productive for all concerned; we want it to benefit the patient to the maximum level; and we want to retain the record of the opinions and recommendations for future reference,” says Sintay. However, there has been no software environment that facilitates quick exchange of information for tumor boards. “We’re interested in the Multidisciplinary Tumor Board module because we anticipate it making preparation less complicated and communication easier.”
For each weekly conference, a nurse navigator spends a half day or longer in preparation, assembling all the history, scans, reports, and other data points required for every patient to be reviewed. In addition to the time involved, there is always a risk that some relevant information may be missed in this manual process. The extensive preparation time also limits the cases that the board can review. “Patients can come up at the last minute and you don’t want to have to wait a week to discuss them. Having the ability to rapidly add a patient would definitely improve our ability to respond,” says Sintay.
When fully configured, the Multidisciplinary Tumor Board module will automate the process. “We can, very quickly, within a few clicks, select patients for our tumor conference, and 360 Oncology receives all the information automatically, thereby saving staff time, and also improving the speed at which we can add patients,” says Sintay.
Sintay also sees unimpeded access to the Multidisciplinary Tumor Board as a distinct advantage. 360 Oncology is contained in the Cloud and sits independent from other databases and medical record systems. The tumor board presentation can be accessed securely from any computer system through a web browser. “This access is important in multidisciplinary care, because often, you’re dealing with multiple physician practices that don’t have the same computer network” says Sintay. “360 Oncology will work very fluidly, no matter what device or system people are using for access.”
Sintay considers 360 Oncology to be a platform for the future of big data. “The Multidisciplinary Tumor Board captures and converts discussions, recommendations, and patient treatment into useful data for future decision-making. I think that’s needed. That’s where the potential of something like 360 Oncology is going to be the greatest: in capturing all of the important information in one place and making it easy to recall or mine the data in the future.”