The impact of a digital solution on case discussion time at tumor boards.

Abstract

e18028 Background: A multidisciplinary tumor board (MTB) provides an interdisciplinary approach for decision-making in cancer care. Information factors such as, multiple data sources, incomplete or missing information and teleconferencing failures, have been identified as issues contributing to variability in MTB conduction and impact. Little is known about how digital tumor board solutions can optimize MTB meeting conduction. Methods: A prospective IRB approved cohort study was undertaken to evaluate the time for patient case discussions,before and after the implementation of the NAVIFY Tumor Board (NTB) solution, at University of Missouri Health Care. Data was collected using a digital time-tracking application. The NTB manual version was implemented via a phased roll-out (Breast May 18, 2018; Gastrointestinal (GI) Jul 11, 2018; ENT Oct 30, 2018 – no manual version phase). Subsequently, the integrated version was introduced (Oct 4, 2018) whereby automated electronic medical record (EMR) data extraction was enabled. Results: Patient case discussion time was recorded at 138 MTBs (1109 patient cases) during 2018 (Breast 40 MTB; 236cases / GI 49 MTB; 389 cases / ENT 49 MTBs; 484 cases). Case discussion time significantly reduced at the Breast MTB (6.6mins to 5.3 mins; p-value = 0.01). Case discussion time at ENT MTB and GI MTB showed no significant change (Table 1). Time variance in case discussions significantly decreased post-NTB implementation at the Breast MTB (p-value = 0.008). For the GI & ENT MTBs, there was no significant difference post-NTB implementation (GI p-value =0.199; ENT p-value = 0.511), however, variance was already sma Conclusions: Introduction of the NTB reduced the time spent discussing cases for the Breast MTB, but showed no change forGI MTB and ENT MTB. Interestingly, case discussion times converged to between 5.5 - 6.5 minutesirrespective of the MTB type. Furthermore, variance decreased or was already small, for all MTB types. Both observations suggest that NTB standardized the case discussion process, perhaps because it created a common format for case presentation. A common workflow tool for MTB meeting conduction could ensure availability of all required data, increase efficiency of therapy decision-making, and lead to higher throughput of cases resulting in shorter time-to-treatment.