Linking Community Cancer Center Physicians to Disease Site-specific Experts

Abstract

The goal of this project is to improve the quality of cancer care across US regions by connecting community cancer center radiation oncologists with highly specialized, disease site-specific radiation oncologists. We have developed a website named Chartrounds.com which allows community radiation oncologist members to interact online with disease site-specific specialists and their peers on a scheduled basis in order to present and review radiation oncology treatment plans and cases in real time. Disease sites currently include breast, head and neck, gastrointestinal, gynecologic, prostate, lymphoma and lung cancers. 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. To date, 475 community radiation oncology physician members from 49 states have enrolled online. In the initial 14-month period (December 2011-February 2012), 19 disease site-specific specialists have lead 102 chart rounds sessions with an average attendance ratio of 6 community physician members to 1 disease site-specific specialist. On a 5-point Likert scale with 5 representing the greatest impact possible, the mean response to feedback questions is as follows: session quality: 4.6, time used effectively: 4.5, discussions relevant to daily practice: 4.7, session is likely to result in a change in practice: 4.2. More specifically, members reported that they would make the following changes in their practice: change in clinical management of the radiation patient: 35%, change in the selection of patients for radiation: 17%, change in radiation fields: 15%, change in radiation prescription dose: 9%. The Chartrounds.com website appears to be making an impact on radiation oncology practice resulting in changes in management and treatment of patients in community cancer centers. Future directions of this project are aimed at demonstrating how these changes could result in significant improvements in cancer care across the United States.