Delivering tertiary tuberculosis care virtually.

ABSTRACT

OBJECTIVE: To assess the impact of a virtual multidisciplinary team (MDT) review panel in reducing travel for children with a rare disease (tuberculosis (TB)) without compromising clinical outcomes. DESIGN: Retrospective review of patients discussed in a virtual MDT panel. Independent pre-intervention and post-intervention data from Public Health England. SETTING: Paediatric departments across North West England. PATIENTS Children aged <16 years with suspected TB infection/disease. INTERVENTION Weekly, virtual MDT discussion between district paediatricians and a tertiary TB team. MAIN OUTCOME MEASURE: Care closer to home, time from presentation to treatment. RESULTS: 45% (37 of 82) children received care closer to home. Median time from presentation to treatment reduced by 28% (from 18 to 13 days). 21% more children were diagnosed before developing symptoms (76% of children presented with symptoms pre-intervention, 55% post-intervention). 5 children incorrectly labelled with latent TB infection were treated for TB disease. CONCLUSIONS: A clinical network supported by virtual MDT reviews can improve treatment for children with rare diseases while providing care close to home.