Virtual multi-institutional tumor board: Feasibility and physicians acceptance, a GSTU foundation project in Sicily

ABSTRACT

Introduction & Objectives: Multidisciplinary tumor boards (MTBs) play a pivotal role in patients’ clinical management and decision-making process. Main barriers to achieve efficient MTBs, are lack of time and geographical distance. COVID-19 pandemic represented an exceptionalobstacle. Telehealth practice has recently expanded including live video conferences and remote patient visit. The elaboration of an efficient virtual(v)MTB during COVID-19 pandemic is a need and a key-point to realize a successful oncology team and to increase a network among healthprofessionals and institutions. Objective of the study was to assess the mode of operating of our vTMB and to evaluate satisfaction and concernsof participating physicians through a dedicated survey.Materials & Methods: A project for a virtual multi-institutional uro-oncological MTB was activated in Sicily. The vMTB was structured according to aBowen framework method, employing a cloud-based virtual platform (Navify®). A 5-point Likert scale measured acceptability, appropriateness, andfeasibility of the instrument. Consensus on patients’management was voted electronically and approved if at least 75% of consensus was reached.Decisions were matched to recent medical literature and verified as adhering to the guidelines. After the first 3 months of activity a structured surveywas carried out among the members of the vMTB to investigate their satisfaction, adherence and concerns.Results: The vMTB started in September 2020. Up to the end of December 2020, 13 virtual meetings (60-90 min each) were holded and 77cases of urological tumors were discussed. Overall, 18 hospital units and 48 specialists joined the meetings. The survey conducted among the 48participating physicians, positively highlighted the impact of the project 48 (100%) preferred virtual to in-person MTB, 44 (91%) were satisfied ofthe quality of clinical information;46 (96%) on equity of care;42 (88%) on collaboration among specialists;42 (88%) on method standardizationand 37 (77%) on data security, tracking, storage, and availability.Conclusions: vMTB represents a unique opportunity to optimize multidisciplinary patient management. Our experience shows a rapid adaptation of physicians to vMTB. However, legal and technical issues remain fields of concern and must be carefully checked. Acknowledgments Thanks to the GSTU foundation for Technical and Editing support