Improving cancer care by linking community cancer center physicians to breast cancer disease site-specific experts.

Abstract

70 Background: The goal of this project is to improve the quality of cancer care across the U.S. by connecting community cancer center radiation oncologists with highly specialized, disease site-specific radiation oncologists. Methods: We have developed a website named chartrounds.com that allows community radiation oncologist members to interact online in a peer review forum with disease site-specific specialists on a scheduled basis. At the conclusion of each session, participants are asked to complete a questionnaire which requests feedback on the quality and relevance of the session and the manner in which it might result in changes to their practice. Results: To date, 575 community radiation oncology physician members from 50 states have enrolled online. In the initial 18-month period, nine disease site-specific specialists have led 81 breast-specific chart rounds sessions with an average attendance ratio, during the past six months, of eight community physician members to one breast cancer disease site-specific specialist. From 309 initial responses, on a five-point Likert scale with five representing the greatest impact possible, the mean response to feedback questions is as follows: session quality; 4.7, time used effectively; 4.6, discussions relevant to daily practice; 4.7, session is likely to result in a change in practice; 4.0. More specifically, 139 members reported that they would make the following changes in their practice: change in clinical management of the radiation patient: 37%, change in the selection of patients for radiation: 22%, change in the technical delivery of radiation including target, field and dose adjustments: 20%. Conclusions: The chartrounds.com website appears to be making an impact on individual radiation oncology practices resulting in changes in management and the delivery of treatment to patients in community cancer centers. Future directions of this project are aimed at demonstrating how these changes may result in significant improvements in survival of breast cancer patients across the U.S. This work is funded by the Improving Cancer Care Grant of the ASCO Conquer Cancer Foundation supported by Susan G. Komen for the Cure.