Utilization of a Virtual Tumor Board for the Care of Patients With Renal Masses: Experience From a Quality Improvement Collaborative.

Abstract

Multidisciplinary tumor board (MDTB) meetings are useful sources of insight and collaboration when establishing treatment approaches for oncologic cases. However, such meetings can be time intensive and inconvenient. We implemented a Virtual Tumor Board (VTB) within Michigan Urological Surgery Improvement Collaborative (MUSIC) to discuss and improve the management of complicated renal masses (RMs). Urologists were invited to discuss decision-making for RMs through voluntary engagement. Communication was performed exclusively through email. Case details were collected and responses were tabulated. All participants were surveyed about their perceptions of the VTB. 50 RM cases were reviewed in a VTB that included 53 urologists. Patients ranged from 20-90 years old and 94% had localized RM. The cases generated 355 messages, ranging from 2-16 (median 7) per case; 144 responses (40.6%) were sent via smart-phone. All urologists (100%) who submitted to the VTB had their questions answered. The VTB provided suggestions to those with no stated treatment plan in 42% of cases, confirmed the physician's initial approach to their case in 36%, and offered alternative approaches in 16% of cases. 83% of survey respondents felt the experience was "Beneficial" or "Very Beneficial" and 93% stated increased confidence in their case management. MUSIC's initial experience with a VTB showed good engagement. The format reduced barriers to multi-institutional and multi-disciplinary discussions and improved the quality of care for selected patients with complex RMs.