Use of the Internet to connect radiation oncologists and medical oncologists with disease site-specific experts: 3-year outcomes of chartrounds.com.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 241-241 ◽  
Author(s):  
Patricia H. Hardenbergh ◽  
Brigitta Gehl ◽  
Kimberly Anne Lyons-Mitchell
Keyword(s):  
Radiation Oncology ◽  
Cancer Care ◽  
Medical Oncology ◽  
Tumor Board ◽  
Site Specific ◽  
Radiation Oncologists ◽  
Medical Oncologists ◽  
Tumor Boards ◽  
Disease Site ◽  
The Impact

241 Background: The purpose of this project is to improve the quality of cancer care by connecting disease site-specific experts with community oncologists through web-based technology. Methods: Chartrounds.com is a conferencing web-site developed to allow community oncologists to present real cases to disease site specialists in oncology on a scheduled basis. Chartrounds was developed initially for radiation oncologists and subsequently has expanded to include multidisciplinary tumor boards and medical oncology specific sessions. Presently 43 disease site expert oncologists including surgeons, medical oncologists and radiation oncologists from 38 academic institutions in the US host sessions. Feedback reports following the completion of each session were designed to assess the impact of the project. Results: Since its inception in December 2010, 43 disease site-specialists have lead 366 sessions, connecting 3,793 participating oncologists from all 50 US states and 24 countries.Broken down by specialty, 348 radiation oncology sessions have linked 3,632 participants, 14 medical oncology specific and multidisciplinary tumor board sessions have included 161 participants. On a 5 point Likert scale with 5 representing the greatest possible impact, the mean response to feedback questions is as follows: session quality: 4.7 for radiation oncology, 4.6 for multidisciplinary; time used effectively: 4.6 for radiation oncology, 4.5 for multidisciplinary; discussions relevant to daily practice: 4.6 for radiation oncology, 4.6 for multidisciplinary; session is likely to result in a change of practice: 4.0 for radiation oncology, 4.0 for multidisciplinary. Chartrounds sessions qualify for 1 CME credit and is approved for a practice quality improvement project by the American Board of Radiology. Conclusions: Chartrounds.com is impacting oncology practices which results in changes in community practice. Future directions of this project include providing chartrounds sessions for oncology nurses and providing a library of video recorded archived sessions. This work has been funded by the Improving Cancer Care Grant of the ASCO Conquer Cancer Foundation.

Improving cancer care by linking community cancer center physicians to disease site-specific experts.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 287-287
Author(s):  
Patricia H. Hardenbergh
Keyword(s):  
United States ◽  
Radiation Oncology ◽  
Cancer Care ◽  
The United States ◽  
Practice Change ◽  
Cancer Center ◽  
Site Specific ◽  
Radiation Oncologists ◽  
Feedback Questionnaire ◽  
Disease Site

287 Background: The goal of this project is to improve quality of cancer care across the United States by connecting community cancer center radiation oncologists with highly specialized, disease site-specific radiation oncologists through the use of online technology. Methods: We have developed a website named chartrounds.com which allows community radiation oncologists to interact online with disease 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, central nervous systems, pediatric, lymphoma and lung cancers. At the conclusion of each session, participants are asked to complete a feedback questionnaire requesting feedback on quality and relevance of the session and the manner in which it might result in practice changes. Results: 650 community radiation oncology physician members from 49 states and 19 countries have enrolled online. In the initial 18-month period (12/2010-6/2012), 23 disease specialists have lead 188 chart rounds sessions with an average attendance ratio of 10 community physician members to 1 disease 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: 4.7, time used effectively: 4.6, discussions relevant to daily practice: 4.7, session is likely to result in a change in practice: 4.0.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%. Conclusions: Chartrounds.com appears to be impacting 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. This work is funded by the Improving Cancer Care Grant of the ASCO Conquer Cancer Foundation.

Improving cancer care by linking community cancer center physicians to breast cancer disease site-specific experts.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 70-70
Author(s):  
Patricia H. Hardenbergh
Keyword(s):  
Breast Cancer ◽  
Radiation Oncology ◽  
Cancer Care ◽  
Practice Change ◽  
Cancer Center ◽  
Cancer Disease ◽  
Site Specific ◽  
Radiation Oncologists ◽  
Disease Site ◽  
The U.S

70 Background: The goal of this project is to improve the quality of cancer care across the U.S. by connecting community cancer center radiation oncologists with highly specialized, disease site-specific radiation oncologists. Methods: We have developed a website named chartrounds.com that allows community radiation oncologist members to interact online in a peer review forum with disease site-specific specialists on a scheduled basis. 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. Results: To date, 575 community radiation oncology physician members from 50 states have enrolled online. In the initial 18-month period, nine disease site-specific specialists have led 81 breast-specific chart rounds sessions with an average attendance ratio, during the past six months, of eight community physician members to one breast cancer disease site-specific specialist. From 309 initial responses, on a five-point Likert scale with five representing the greatest impact possible, the mean response to feedback questions is as follows: session quality; 4.7, time used effectively; 4.6, discussions relevant to daily practice; 4.7, session is likely to result in a change in practice; 4.0. More specifically, 139 members reported that they would make the following changes in their practice: change in clinical management of the radiation patient: 37%, change in the selection of patients for radiation: 22%, change in the technical delivery of radiation including target, field and dose adjustments: 20%. Conclusions: The chartrounds.com website appears to be making an impact on individual radiation oncology practices resulting in changes in management and the delivery of treatment to patients in community cancer centers. Future directions of this project are aimed at demonstrating how these changes may result in significant improvements in survival of breast cancer patients across the U.S. This work is funded by the Improving Cancer Care Grant of the ASCO Conquer Cancer Foundation supported by Susan G. Komen for the Cure.

scholarly journals NCOG-75. ESTIMATED PHYSICIAN COST OF A NEURO-ONCOLOGY MULTIDISCIPLINARY TEAM (MDT) TUMOR BOARD MEETING AT A SINGLE ACADEMIC CENTER

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii146-ii146
Author(s):  
Brett Schroeder ◽  
Jerome Graber ◽  
Emmanuel Cuevas
Keyword(s):  
Performance Metrics ◽  
Tumor Board ◽  
Multidisciplinary Teams ◽  
Radiation Oncologists ◽  
Annual Salary ◽  
Academic Center ◽  
Tumor Boards ◽  
The Mean ◽  
Patient Prognosis ◽  
The Impact

Abstract BACKGROUND Multidisciplinary teams (MDTs) to improve coordination across disciplines have become commonplace in oncology. Quantifying the impact of MDTs is challenging, and they carry significant costs. Weekly neuro-oncology tumor boards are attended by neuro-oncologists, neurosurgeons, radiation-oncologists, neuro-radiologists, neuro-pathologists, and support staff including mid-level practitioners, research coordinators, social workers, nurses and trainees. Our aim was to estimate costs associated with neuro-oncology MDTs. METHODS The estimated physician cost of MDT meetings were calculated from reported salaries of each physician specialty. Annual salaries from the Doximity 2019 Physician Compensation Report (PCR) included data for 4 neurosurgeons, 4 radiation-oncologists, 2 radiologists, 2 oncologists, and 2 neurologists. Medscape 2019 PCR data was compiled for 4 general surgeons, 2 radiologists, 2 oncologists, 2 pathologists, and 2 neurologists. The Physician Wages Across Specialties by Leigh in 2011 (JAMA) was utilized for 4 neurosurgeons, 4 radiation oncologists, 2 oncologists, and 2 neurologists. Annual salary data was divided by annual hours per specialty as reported by the Annual Work Hours Across Specialties, 2011. These values were then applied to an MDT for one patient, one hour, weekly, and annually. RESULTS The Doximity 2019 PCR yielded a per meeting cost of $2,520.84, and an annual cost of $131,083.68. The Medscape 2019 PCR produced a cost of $1,570.60 weekly, and $81,671.20 annually. JAMA data estimated a per meeting cost of $1,448.06, and $75.299.12. The mean per meeting and annual costs were $1846.50, and $96,018.00, respectively. With 6-10 cases per MDT, the mean costs per patient were $184.65 to $307.75. CONCLUSIONS Costs of MDT are not negligible. The impact of MDTs on patient outcomes are harder to quantify, but evidence exists that organized MDTs improve patient prognosis, and unorganized MDTs may negatively affect prognosis. Processes to streamline MDTs could help answer outcomes research questions, improve efficiency, and generate clinically relevant performance metrics.

Improvement of cancer care by linking community cancer center oncologists to disease site-specific experts.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6641-6641
Author(s):  
Patricia H. Hardenbergh ◽  
Calloway B May ◽  
Kimberly Anne Lyons-Mitchell
Keyword(s):  
Radiation Oncology ◽  
Cancer Care ◽  
Daily Practice ◽  
Practice Change ◽  
Cancer Center ◽  
Site Specific ◽  
Radiation Fields ◽  
Community Physician ◽  
Disease Site

6641 Background: To improve the quality of cancer care across US by connecting community cancer center oncologists with highly specialized, disease site-specific oncologists through the use of online technology. Methods: Chartrounds.com was developed which allows community oncologists to interact online with disease site-specific oncologists and their peers on a scheduled basis in order to present and review treatment management and specific cases. Disease sites include breast, head and neck, gastrointestinal, gynecologic, prostate, central nervous systems, pediatric, lymphoma, lung cancer and palliative care. 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 practice changes. Results: To date, 825 community radiation oncology physician members from 50 states and 19 countries have enrolled online. In the initial 25-month period (12/2010-1/2013), 35 disease site-specific specialists have lead 256 chart rounds one-hour sessions with an average attendance ratio of 15 community physician members to 1 disease site-specific specialist. On a 5 point scale with 5 representing the greatest impact possible, of 1,756 responses the mean score to feedback questions is as follows: session quality: 4.6, time used effectively: 4.6, discussions relevant to daily practice: 4.6, session is likely to result in a change in practice: 4.0.Members reported that they would make the following changes in their practice: change in clinical management of the radiation patient: 40%, change in the selection of patients for radiation: 10%, change in radiation fields: 15%, change in radiation prescription dose: 10%. Conclusions: The Chartrounds.com program appears to be making an impact on the quality of radiation oncology practices resulting in changes in management and treatment of patients in community cancer centers. Future directions of this project are aimed at continuing to develop the site for medical oncologists and multidisciplinary tumor conferences. This work is funded by the Improving Cancer Care Grant of the ASCO Conquer Cancer Foundation supported by Susan G. Komen for the Cure.

Evaluation of Activation of a NCI National Clinical Trials Network (NCTN) Study S1826 for Hodgkin Lymphoma (HL) at Children's Oncology Group (COG) Institutions

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 20-20
Author(s):  
Sharon M. Castellino ◽  
Angela Punnett ◽  
Susan K Parsons ◽  
Nicholas P. DeGroote ◽  
Sally Muehle ◽  
...  
Keyword(s):  
Pediatric Oncology ◽  
Research Funding ◽  
Design Research ◽  
Medical Oncology ◽  
Adolescent And Young Adult ◽  
Novel Agents ◽  
Successful Implementation ◽  
Institutional Infrastructure ◽  
Medical Oncologists ◽  
Tumor Boards

Background: HL is an adolescent and young adult (AYA) cancer that lacks uniform approaches across medical and pediatric oncology. Differences include risk classification, chemotherapy backbone and use of radiation therapy. Heterogeneity in institutional programs and resources for AYAs adds to the gap in understanding why outcomes for AYA HL differ. In order to expedite equitable access to novel agents for AYA patients by medical and pediatric oncology providers, a NCTN facilitated trial for advanced stage HL was launched. The SWOG-led S1826 trial (NCT03907488), open to patients > 12 years of age, was activated in July 2019. We assessed barriers and facilitators to trial activation at COG institutions for this first in-kind approach. Methods: A web-based survey was distributed through the COG communications office to institutional principal investigators (PIs) of 216 institutions in North America. To achieve optimal response rates, the survey was distributed in four waves over a 6-week period. Branching logic differentiated questions for institutions that had opened or planned to open the trial vs. those who did not. Topics included institutional characteristics, joint partnership with medical oncologists to activate AYA trials, and specific barriers for opening this trial. Descriptive statistics were calculated using SAS v.7.1. Results: The response rate was 73% with 158 unique responses among 216 COG institutions queried. Among responding institutions 24% were freestanding children's hospitals; 18% were NCI-designated cancer centers. 55% of respondents indicated a known affiliation with another NCTN cooperative group other than COG. 31% indicated prior experience in participating in a non-COG led NCTN trial for other diseases. 42% of institutions reported a central trials infrastructure for joint pediatric and medical oncology trials. 44% indicated use of the central IRB mechanism, and 4% used a provincial IRB. While 40% had an established AYA oncology program, 30% reported regular lymphoma tumor boards with medical oncology; 8% indicated the ability to see AYA lymphoma patients in a joint pediatric and medical oncology clinic. The trial is open at 79/158 (50%) COG institutions to date and an additional 56 indicated future intent to open the trial. Among 135 COG institutions with open or intent-to-open status, 73% of institutional principal investigator (PI) were pediatric oncologists, 24% were medical oncologists and 4% were joint PIs. PI determination was based on: enrolling as a COG-only site (57%); institutional policy (5%); a discussion among investigators (23%); or other factors (14%). These were categorized as: more resources or anticipated patients in medical oncology (n=4); the trial being opened in medical oncology before pediatrics (n=11); being open in pediatrics before medical oncology (n=2); no interface for joint studies (n=1). Among the 14% of respondents who indicated the trial would not be opened, a competing trial was the reason in 35%. Other reasons included: lack of awareness of the trial, concerns about study design or chemotherapy backbone, lack of easily accessible protocol documents, anticipated lack of accrual, concerns around funding support, challenges with regulatory support, data management, or institutional process for medical and pediatric joint trials. Respondents' recommendations for facilitating activation of AYA intergroup studies include needs for: increased resources and funding; guidance on communication and navigation with medical oncologists for managing joint trials; institutional infrastructure for AYA trials; clearer rationale for a change in the chemotherapy backbone relative to prior COG studies; accessibility and consistency of protocol study naming conventions and protocol documents (i.e. therapy roadmap) on the COG electronic site. Conclusions: Successful implementation of AYA trials is germane to early access to novel agents for younger adolescents. Overall, COG institutions indicate a high level of endorsement for a NCTN AYA trial for HL with 85% indicating activation completed or planned. This survey suggests that AYA trials can be implemented successfully in a network but require education, early communication between pediatric and medical oncologists, and flexible infrastructure for all group participants. (Funding: U10CA180886, U10CA180888, and UG1CA233230) Disclosures Parsons: Seattle Genetics: Consultancy. Herrera:Bristol Myers Squibb: Consultancy, Other: Travel, Accomodations, Expenses, Research Funding; Merck: Consultancy, Research Funding; Genentech, Inc./F. Hoffmann-La Roche Ltd: Consultancy, Research Funding; Gilead Sciences: Consultancy, Research Funding; Seattle Genetics: Consultancy, Research Funding; Immune Design: Research Funding; AstraZeneca: Research Funding; Karyopharm: Consultancy; Pharmacyclics: Research Funding. Friedberg:Acerta Pharma - A member of the AstraZeneca Group, Bayer HealthCare Pharmaceuticals.: Other; Astellas: Consultancy; Kite Pharmaceuticals: Research Funding; Bayer: Consultancy; Seattle Genetics: Research Funding; Roche: Other: Travel expenses; Portola Pharmaceuticals: Consultancy.

scholarly journals Impact of COVID-19 on Canadian medical oncologists and cancer care: Canadian Association of Medical Oncologists survey report

2020 ◽  
Vol 27 (2) ◽  
Author(s):  
S. Gill ◽  
D. Hao ◽  
H. Hirte ◽  
A. Campbell ◽  
B. Colwell
Keyword(s):  
National Survey ◽  
Health Care Access ◽  
Cancer Care ◽  
English Language ◽  
Treatment Decision ◽  
Cancer Prognosis ◽  
Canadian Association ◽  
Medical Oncologists ◽  
Personal Challenges ◽  
The Impact

  Background  The covid-19 pandemic has presented unprecedented professional and personal challenges for the oncology community. Under the auspices of the Canadian Association of Medical Oncologists, we conducted an online national survey to better understand the impact of the pandemic on the medical oncology community in Canada. Methods  An English-language multiple-choice survey, including questions about demographics, covid-19 risk, use of personal protective equipment (ppe), personal challenges, and chemotherapy management was distributed to Canadian medical oncologists. The survey was open from 30 March to 4 April 2020, and attracted 159 responses. Results  More than 70% of medical oncologists expressed moderate-to-extreme concern about personally contracting covid-19 and about family members or patients (or both) contracting covid-19 from them. Despite that high level of concern, considerable variability in the use of ppe in direct cancer care was reported at the time of this survey, with 33% of respondents indicating no routine ppe use at their institutions and 69% indicating uncertainty about access to adequate ppe. Of the respondents, 54% were experiencing feelings of nervousness or anxiety on most days, and 52% were having feelings of depression or hopelessness on at least some days. Concern about aging parents or family and individual wellness represented the top personal challenges identified. The management of cancer patients has been affected, with adoption of telemedicine reported by 82% of respondents, and cessation of clinical trial accrual reported by 54%. The 3 factors deemed most important for treatment decision-making were cancer prognosis and anticipated benefit from treatment, risk of treatment toxicity during scarce health care access, and patient risk of contracting covid-19. Conclusions This report describes the results of the first national survey assessing the impact of the covid-19 on Canadian medical oncologists and how they deliver systemic anticancer therapies. We hope that these data will provide a framework to address the challenges identified.

scholarly journals Digital Tumor Board Solutions Have Significant Impact on Case Preparation

2020 ◽  
pp. 757-768
Author(s):  
Richard D. Hammer ◽  
Donna Fowler ◽  
Lincoln R. Sheets ◽  
Athanasios Siadimas ◽  
Chaohui Guo ◽  
...  
Keyword(s):  
Care Center ◽  
Tumor Board ◽  
Preparation Time ◽  
Implementation Phase ◽  
Health Care Center ◽  
Multiple User ◽  
Tumor Boards ◽  
User Groups ◽  
The Impact ◽  
Nose And Throat

PURPOSE Multidisciplinary tumor boards (TBs) are the gold standard for decision-making in cancer care. Variability in preparation, conduction, and impact is widely reported. The benefit of digital technologies to support TBs is unknown. This study evaluated the impact of the NAVIFY Tumor Board solution (NTB) on TB preparation time across multiple user groups in 4 cancer categories: breast, GI, head and neck (ie, ear, nose, and throat, or ENT), and hematopathology. METHODS This prospective study evaluated TB preparation time in multiple phases pre- and post-NTB implementation at an academic health care center. TB preparation times were recorded for multiple weeks using a digital time tracker. RESULTS Preparation times for 59 breast, 61 GI, 36 ENT, and 71 hematopathology cancer TBs comparing a pre-NTB phase to 3 phases of NTB implementation were evaluated between February 2018 and July 2019. NTB resulted in significant reductions in overall preparation time (30%) across 3 TBs pre-NTB compared with the final post-NTB implementation phase. In the breast TB, NTB reduced overall preparation time by 28%, with a 76% decrease in standard deviation (SD). In the GI TB, a 23% reduction in average preparation time was observed for all users, with a 48% decrease in SD. In the ENT TB, a 33% reduction in average preparation time was observed for all users, with a 73% decrease in SD. The hematopathology TB, which was the cocreation partner and initial adopter of the solution, showed variable results. CONCLUSION This study showed a significant impact of a digital solution on time preparation for TBs across multiple users and different TBs, reflecting the generalizability of the NTB. Adoption of such a solution could improve the efficiency of TBs and have a direct economic impact on hospitals.

scholarly journals Assessing the Impact of the COVID-19 Outbreak on the Attitudes and Practice of Italian Oncologists Toward Breast Cancer Care and Related Research Activities

2020 ◽  
Vol 16 (11) ◽  
pp. e1304-e1314 ◽  
Author(s):  
Francesca Poggio ◽  
Marco Tagliamento ◽  
Massimo Di Maio ◽  
Valentino Martelli ◽  
Andrea De Maria ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Weekly Paclitaxel ◽  
Breast Cancer Care ◽  
Related Research ◽  
Research Activities ◽  
Monitoring Therapy ◽  
Medical Oncologists ◽  
Metastatic Setting ◽  
The Impact

PURPOSE: To investigate the impact of the COVID-19 outbreak on the attitudes and practice of Italian oncologists toward breast cancer care and related research activities. METHODS: A 29-question anonymous online survey was sent by e-mail to members of the Italian Association of Medical Oncology and the Italian Breast Cancer Study Group on April 3, 2020. Only medical oncologists (both those in training and specialists) were invited to complete the questionnaire. RESULTS: Out of 165 responding oncologists, 121 (73.3.%) worked in breast units. In the (neo)adjuvant setting, compared with before the emergency, fewer oncologists adopted weekly paclitaxel (68.5% v 93.9%) and a dose-dense schedule for anthracycline-based chemotherapy (43% v 58.8%) during the COVID-19 outbreak. In the metastatic setting, compared with before the emergency, fewer oncologists adopted first-line weekly paclitaxel for HER2-positive disease (41.8% v 53.9%) or CDK4/6 inhibitors for luminal tumors with less-aggressive characteristics (55.8% v 80.0%) during the COVID-19 outbreak. A significant change was also observed in delaying the timing for monitoring therapy with CDK4/6 inhibitors, assessing treatment response with imaging tests, and flushing central venous devices. Clinical research and scientific activities were reduced in 80.3% and 80.1% of respondents previously implicated in these activities, respectively. CONCLUSION: Medical oncologists face many challenges in providing cancer care during the COVID-19 outbreak. Although most of the changes in their attitudes and practice were reasonable responses to the current health care emergency without expected major negative impact on patient outcomes, some potentially alarming signals of undertreatment were observed.

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