Interdisciplinary Coordination for Breast Healthcare

Abstract

Breast disease diagnosis and management is a quintessential example of a process requiring multidisciplinary coordination. European guidelines consider a coordinated team approach to be the standard of care. While the necessity of multidisciplinary coordination of breast healthcare is recognized in the US, its adoption in a practical sense has been fragmented and incomplete. Interdisciplinary communication and coordination has become the cornerstone of effective cancer care, but it is not supported financially or practically by a healthcare infrastructure that primarily focuses on the reimbursement of individual specialists for procedures and therapies rather than the process by which these therapies are optimally selected and integrated. Practical obstacles to interdisciplinary care are complicated by the heterogeneity of healthcare systems that must necessarily adapt to differences in population distribution, variability in access to care, availability of trained specialists, varied models of medical care delivery, and structure of insurance coverage. The American Society of Breast Disease (ASBD) is a multidisciplinary group that focuses on how interdisciplinary breast cancer care can be successfully delivered. Since much of quality improvement hinges on outcome measurement, metrics of quality interdisciplinary care are needed to assess how well we are doing in different healthcare venues. In November 2006, the ASBD held a colloquium entitled Ensuring Optimal Interdisciplinary Breast Care in the United States, the purpose of which was to develop a framework of quality indicators related to multidisciplinary and interdisciplinary care that can be used to assess the degree to which interdisciplinary communication and coordination is taking place.