Multi-Disciplinary Team Meetings (MDT) are a cornerstone of cancer care. Several recent studies [1-3] clearly demonstrate that MDTs, or tumor boards, provide significant value in patient diagnosis and treatment .
However, there are significant challenges in keeping both the preparations and the actual meetings efficient. A common IT platform for radiology and pathology images and reports not only increases efficiency, but also improves information sharing, enables a team approach to the care process and reduces the risk of errors.
Increasing efficiency with modern technology
MDT meetings involve people from several specialist groups, such as surgeons, pathologists, radiologists, and oncologists. Their time is extremely expensive. Accordingly, it is in the best interests of hospitals to increase the effectiveness of these meetings, with the aim of reducing the time spent per patient and improving the treatment .
Modern technology and applications in healthcare provide opportunities to increase the flexibility and effectiveness of MDT meetings. For example, we have seen a wide adoption of video conference systems such as Lync, which opens up for virtual meetings. More IT systems in healthcare also support BYOD (Bring Your Own Device), with unified viewers allowing physicians to use any device connected to the internet to show images and patient information or to participate in meetings. Clinical applications for medical images have been linked together or placed on top of a common archive with close integration to the EMR. However, the technology shift that truly allows for improvements in the MDT workflow is the increased adoption of digital pathology, enabling an approach towards truly integrated diagnostics and collaborative care. Let’s take a look at the MDT process.
Prior to the meeting specialists select and prepare their diagnostic images and annotations. The tools used for the preparation and presentation of the selected images vary with the specialist type and available IT tools. The radiologist usually has access to MDT functionality in the PACS, while the pathologist in the traditional workflow would need to manually select appropriate glass slides and scan them or take pictures, or even physically send the glass itself to the meeting room. With a joint platform, pathologist and radiologist can add images to any scheduled MDT during the actual review work together with annotations, streamlining the preparation workflow. Colleagues can also access the total presentation material to ensure that the proper information is available at the meeting and compare reports prior the meeting to detect discordances.
During the meeting it is not uncommon to have logistical problems relating to samples being delivered in time to the right room, connecting virtual participants and getting different IT systems to work together. If the pathologist still uses the viewer that comes with the scanner for digital pathology, images need to be manually retrieved from the server and matched to the case annotations. If the digital pathology system comes from a different vendor than that used during the MDT it is also most likely that the technologies will be incompatible and additional time is needed to gather all material.
With a common platform, all prepared images and documents are accessible and can be viewed either by logging in to the radiology PACS or to the digital pathology solution. Hence, using one system avoids troubles with connecting different systems and the change between presenting monitors. Not least, it minimizes the risk of irritation among participants and reduces the patient waiting time. Each patient case discussion is estimated to take 4-6 minutes, so even the smallest friction in the preparation and presentation will affect the total effectiveness significantly.
The increased adoption of digital pathology enables fully digital MDTs. By using a joint platform for both radiology and pathology, hospitals can reduce the time necessary for MDT preparation and presentation, thus increasing effectiveness in cancer care.
- Review of ‘The Dream MDT’: Measuring and improving high quality lung cancer outcomes. UKLCC, December 2014
- Benefits of multidisciplinary teamwork in the management of breast cancer, Cath Taylor at all, August 2013
- Experiences of Establishing and Managing a Clinical Multidisciplinary Team Meeting, Deb Rawlings, April 2007
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