Rationale: Multidisciplinary tumor boards (MTBs) are extremely effective in achieving multidisciplinary input for National Comprehensive Cancer Network (NCCN) treatment planning. The American College of Surgeons Commission on Cancer recognizes MTBs as an essential component of excellence in cancer care. National Cancer Institute–designated cancer centers have a responsibility to the community to share new and innovative prevention, diagnostic, treatment, palliation, and survivorship. As seen in the Remote Expert Assessment of Lung Cancer (REAL) program at Hollings Cancer Center (HCC), teleconferencing of virtual thoracic tumor boards allows providers in a geographically remote area access to a multispecialty consultation provided by the thoracic cancer team at the HCC. Since the program’s inception, 41% of patients seeking treatment for lung cancer at the HCC traveled an estimated 150 to 200 miles. Opening access for all rural areas in the state to participate in multidisciplinary virtual tumor boards (VTBs) could impact overall quality of care for South Carolina cancer patients.
Methods: The community physicians provide relevant clinical data, including results of pathology, imaging, and prior treatment. This information is entered into a secure web program, known as RedCap, used for managing databases and online surveys. Outside images are uploaded into a system known as LifeIMAGE Medical Image Exchange System. This platform enables physicians and outside institutions to securely and seamlessly transfer images to MUSC, without delay, and without the need for transporting CDs. There is no need for any special software or complicated training to use this system; LifeIMAGE uses an innovative cloud technology and vendor-neutral platform. During the MTB, the community physicians join the meeting virtually and present their case to the HCC VTB. The presenting physician is able to view the images in conjunction with the MTB team. This program provides community physicians and general oncologists with access to clinical specialists, dedicated radiologists, pathologists, social workers, and clinical trials representatives. Access to the HCC VTB can result in better assessments of oncology patients in rural areas and a decrease in the need for travel to HCC.
Results: In 13 of the 18 cases in which the VTB provided a different recommendation, a less invasive procedure was advocated (46% of the total population). Referring providers verbalized higher satisfaction with this process and were more likely to utilize this program in the future. The REAL Cancer Study increased access to the expertise of an MTB via virtual technology that positively impacted patient outcomes.
