Improving Care Quality with Virtual Tumor Boards Using Videoconferencing Technology

The need for multidisciplinary input in cancer care planning is essential. However, clinicians, particularly those practicing in remote areas, face barriers to accessing multidisciplinary consultations. Virtual tumor boards (VTB) using videoconferencing technology are a promising strategy for meeting this need and therefore may improve the quality of care for patients.

The Lineberger Comprehensive Cancer Center (LCCC) Telemedicine Program recently instituted VTBs in several cancer groups -- including hematologic, breast, gastrointestinal, gynecologic, and head and neck -- to engage community-based clinicians across North Carolina. Community Clinicians access the VTBs from their facility via an interactive video network. To date, approximately 30 cancer cases have been presented at VTBs by community physicians practicing in various N.C. counties. However, there has been no formal evaluation of the VTBs' processes and early outcomes. This study analyzed the VTB program's participant satisfaction as well as impacts of the program on clinician behavior (e.g., treatment decisions and peer consultations).

The team used a case study design to analyze the VTBs in the five cancer fields identified above. Data were collected via direct observation of VTB meetings, surveys of UNC clinician participants, and interviews with community-based and UNC clinician participants.

Findings:  Preliminary findings showed that UNC and community-based participants generally report positive impacts and satisfaction with the tumor board program. The level of participation by community-based physicians, however, was hindered by such factors as scheduling, finding time for non-reimbursable VTB activities, and perceived need. Results suggest that the VTB program is feasible and has potential to improve cancer care for patients whose physicians participate.  An additional planning effort is recommended for clarifying VTB structure and goals for each tumor board group and optimal processes for reducing barriers to participation. This effort coupled with an organized marketing campaign could increase participation by community-based physicians and improve access to multidisciplinary care for a larger number of NC citizens with complex cancer diagnoses. 

Geographic Area(s): Buncombe, Cumberland, Dare, Guilford, Wake and Washington counties

Research Team: Christopher Shea, PhD, MA, MPA, clinical assistant professor of health policy and management (co-principal investigator); Thomas Shea, MD, professor of medicine (co-principal investigator); Stephanie Wheeler, PhD, assistant professor of health policy and management; Bryan Weiner, PhD, professor of health policy and management; Deborah Mayer, PhD, MSN, associate professor of nursing; Lynn Dressler, DrPH, assistant professor of pharmacy; Michael Young, Director of Telemedicine; Christine Lin, MD, hematology/oncology fellow; Randall Teal, MA, research associate; and Sara Jacobs and Lindsey Haynes-Maslow, research assistants.

For more information about this pilot research study, contact Dr. Christopher Shea, co-principal investigator, at Chris_Shea@unc.edu.