The Case for Multidisciplinary Review During Remote Second Opinions

Often referred to as “tumor boards,” multidisciplinary cancer treatment planning conferences can help patients gather input from a diverse panel of experts to holistically inform their care. Specialists range from all areas of cancer treatment, such as surgery, chemotherapy, radiation therapy, pathology, radiology, and genetics, among others.  Review of complex or unusual cases in a tumor board is routine in most cancer centers and considered a marker of high-quality care.

Similarly, online second opinions may also provide cancer patients access to a broad range of expertise globally, while also alleviating the burden and risk of travel when immunocompromised. Virtual or online multidisciplinary second opinions can provide patients with quality review and recommendations on par with those they would receive after undergoing in-person care and can be accomplished asynchronously, freeing up a specialist’s schedule. Second opinion platforms that support independent examination of case elements and collaboration by multiple specialists enable these programs to take on the most complex cases. However, many online platforms are designed to permit case review by only one expert clinician.  While a single clinician’s review may be adequate for some cases, complex and rare cases benefit from a multidisciplinary team. A 2020 study, which examines the impact of multidisciplinary tumor boards on head and neck cancer outcomes, concludes that patients who received multidisciplinary review had significantly lower risk of death and that 'multidisciplinary review should be considered best practice.'

It is no secret that demands on a physician’s time have reached an all time high. Medscape conducted a survey in 2022 across 13,000 physicians and 29 specialties, reporting that 47% of physicians were feeling burned out, citing ‘too many bureaucratic tasks’ and ‘too many hours at work’ as leading contributors. Finding solutions that are easy to use and reduce the administrative burden on physicians is becoming increasingly important. 

Synchronous consultation can be difficult to fit into a physician’s schedule, even through video conference. Second opinion software platforms that allow for multidisciplinary input in an asynchronous manner are a welcome addition to the physician’s busy day. Beyond the noted benefits to the patient, this approach facilitates much needed flexibility for physicians, where they can view and work on these cases at any time and from anywhere, inviting colleagues to view and collaborate on cases when appropriate, and finally rendering a comprehensive recommendation for the patient.  

Prior to the rise of acceptance of telehealth, the benefits of multidisciplinary reviews were primarily reserved for patients seen in-person, local to a center of excellence, or concierge patients who had the means to travel in-person. Covid-19 created an unprecedented shift, creating both challenges and opportunities for cancer patients. Today there are a growing number of options for cancer patients now including multidisciplinary input during remote second opinions. 

The workflow and infrastructure needed for multidisciplinary input into cancer second opinions may also easily be pivoted to second opinions for patients with non-malignant diseases requiring multidisciplinary management, e.g., complex congenital disease in pediatric populations. Platforms with this capability thereby allow health systems to extend their reach to patients who otherwise may not have access to experts, and work towards ensuring that geography  is not a barrier to high-quality care.



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