Balance Needed in Use of Virtual Tumor Boards

By Leah Lawrence - Last Updated: September 20, 2022

With the use of a virtual format, there was a significant increase in overall tumor board attendance and case presentations per meeting, according to a study in JCO Practice.

Researchers at a National Cancer Institute-designated Comprehensive Cancer Center compared 12-month in-person and 12-month virtual tumor board data to assess for differences in attendance and case presentation patterns.

Attendance increased by 46% with the virtual platform compared with in-person meetings (P<.001). This increase occurred across all specialties studied (breast, gastrointestinal, gynecology, liver, lung, melanoma, and urology). There was also a 20% increase in case presentations with the virtual format (P<.001).

In an accompanying editorial, Elan D. Panov, MD, and Katherine A. Enright, MD, MPH, of Trillium Health Partners, Mississauga, Ontario, Canada, called these results impressive, but added that there are still many questions to be answered regarding the use of virtual tumor boards.

For example, does increased quantity of attendance and case presentation correlate with improved quality of patient outcomes?

One of the obvious benefits of a virtual format, they wrote, is increased accessibility.

“Davis et al reported anecdotal evidence that this increase was, in part, from more community oncologists attending the multidisciplinary tumor board of a Comprehensive Cancer Center. Having the ability to log on from wherever you are is a major benefit, given our busy schedules and daily commitments,” they wrote. “Furthermore, having physicians from different community and rural hospitals virtually participate reduces isolation in decision making and, hopefully, improves patient care in smaller centers.”

However, attendance does not equate to active engagement.

The additional case presentations led to an assumption of more positive patient outcomes, but this remains to be measured.

A potential downside of virtual tumor boards is a lack of in-person interactions, Panov and Enright wrote.

“Building a sense of community among health care providers, especially in oncology, is important not only for improving patient care but also for our own well-being in an otherwise challenging field,” they wrote.

In addition, representation of non-oncology physicians and allied health members at these virtual tumor boards is also of importance.

“They play an important role in the care of our patients, and their insights can, and should, help guide management decisions,” they wrote. “Having online access likely makes it easier for non-oncologists to join multidisciplinary tumor boards but that does not mean it happens.”

Finally, Panov and Enright questioned the sustainability of a virtual format due to issues like “Zoom fatigue”. Rather than a continued online-only format, they suggested a modified virtual tumor board that “supplements a potential return in in-person meetings.”

References

Sources: Integrated Multidisciplinary Brain Metastasis Care Reduces Patient Visits and Shortens Time to Adjuvant Irradiation

Virtual Tumor Board: Benefits, Problems, and Finding Balance in a Postpandemic Future

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