Virtual easy-to-access hematology tumor boards: Scaling disease expertise across multiple sites of care across urban and rural Tennessee.

Abstract

570 Background: Tennessee Oncology is a community oncology practice with 90 medical oncologists practicing at 35 urban and rural clinical sites across Tennessee and Northern Georgia. In January 2023, we launched a virtual malignant hematology tumor board (MHTB) to allow the review of patient cases by a centralized collaborative team of physicians with expertise in malignant hematology and hematopathology who are located at four sites of care. Methods: Any provider within the practice can submit a case to the MHTB through the electronic medical record. Cases are reviewed twice monthly via scheduled Zoom meetings. Providers are invited but not expected to attend the scheduled conferences. A summary of the discussion, link to the recording, and time stamp is emailed to the referring providers within 3 days of the discussion. After 6 months of use, an electronic anonymous survey was sent to providers to gauge satisfaction. Results: From January 1 to May 31, 2023, 85 patient cases were submitted for review by the MHTB (average 8.5 cases/conference). Approximately one-third (29/90) of oncologists within the practice submitted at least one case and most users (20/29, 69%) had multiple submissions. Since its inception, patients from 21 clinics and 56 different cities in Tennessee and Northern Georgia have been discussed at the MHTB. Many of these patients reside in rural communities. A survey of participating physicians (n=13, 45%) indicated a high level of satisfaction with the process. All respondents (100%) felt the MHTB improved medical decision-making in a meaningful way. The majority (77%) felt that a virtual format of the tumor board improved utilization and was pleased with the format. Conclusions: The development of a virtual MHTB created an avenue for general oncologists across 35 clinical sites of care to request timely review of complex malignant hematology cases by a centralized team of malignant hematology experts. Ease of case submission, a virtual format, and optional attendance have led to a high level of satisfaction among providers and allowed this initiative to be successfully scaled across the practice.