The evolution of Multidisciplinary Medical Teams – Part 2

Jan Beger

In Part 1 of this series I talked about current pain points around Multidisciplinary Medical Team (MDT) meetings in light of growing demand for such meetings. For the full benefits of MDT collaboration to be achieved, access to improved technology solutions is needed.

Multidisciplinary teamwork does appear to enhance the quality of care. However, poor progress in some areas of multidisciplinary team work may potentially hinder patient treatment [1].

MDT’s are a hugely expensive resource, due to the requirement to have many experts available at the same time. In recent years, the potential for virtual teams in healthcare has been cited as a way to overcome the barriers that time and geography present [2].

Looking forward, the technology used for preparation, the meeting itself and pre-meeting task tracking should be accessible anywhere there is internet access, and at any time. It must be easy to use, from any kind of connected device, just as you (or at least your children) use social networks today. Anyone who is aware of how teenagers use Facebook knows that web-based communication tools can be used creatively and effectively.

Patients need fast, decisive care decisions. Clinicians need instant access to medical exams, documents and images. Hospitals require operational efficiency and regulatory compliance.

The increasing prevalence of cancer coupled with workforce shortages and other time pressures make it ever more important that time spent in MDT meetings is used efficiently [2].

A modern solution for MDT meetings facilitates quality patient care, operational efficiency and collaboration via secure exchange of diagnostic images, patient documents and related information. This needs to be possible between MDT members across organizational boundaries. MDT meeting technology has to evolve to suit all scenarios, from the traditional meeting in the meeting room to fully virtual multidisciplinary team activities. A secure web-based solution that provides communication support for clinicians in geographically distant clinics and hospitals should follow the same standards and function very much like a health information exchange (HIE).

Today in traditional MDT meetings, there are logistical problems with setting up and maintaining participation. Pressures of timing and coordination are identified as challenges to MDT meeting dependability. Difficulties are being experienced by pathology and radiology departments participating fully in several MDT’s. If someone cannot be present they arrange for another to represent them in the discussions. Time spent at meetings, and in preparation for MDT meetings is significant.

Of course, issues of timing and coordinating materials to be reviewed are sometimes irreconcilable.

Materials comprise radiological images, pathological samples, pictures from the bronchoscopy, PET scans, video clips of surgical observations, etc. The exchange of these patient materials with outside institutions is a cause for concern when full, compliant data are not made available in a timely fashion. Staffs at all hospitals need to liaise so that the correct materials are sent and received on time, to facilitate review by the radiologist and pathologist before the MDT meeting. These items from outside must be separated from in-house material and be returned to the source after the meeting.

The MDT meeting outcome – recommendations/ decisions – can only be as good as the information available to the MDT at the meeting. For interpretative tasks in radiology and pathology, contextual information is important for accurate interpretation. Lack of information is a potential source of medical error, which can have potential impact to the overall patient management process.

As you can imagine, participants place a high value on the availability of radiology images and pathology sample images at MDT meetings.

A lack of coordination of care and communication increases stress for patients and families [3].

A virtual MDT meeting solution finally and most importantly helps the patient. They benefit from their case being discussed by a wider pool of experts than may be locally available. This can help limit potential delays in treatment and enhance timely resolution of issues as they arise.

Until next time,

Jan Beger

 


[1] Review of ‘The Dream MDT’: Measuring and improving high quality lung cancer outcomes. UKLCC, December 2014

[2] Benefits of multidisciplinary teamwork in the management of breast cancer, Cath Taylor at all, August 2013

[3] Experiences of Establishing and Managing a Clinical Multidisciplinary Team Meeting, Deb Rawlings,  April 2007


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