Soo Khee Chee, Al Jajeh Issam, Quah Raymond, Seah Hoe Kuen Brandon, Soon Sharon, Walker Espen
General Surgery Department, Farrer Park Hospital, Singapore.
Department of Pathology, Farrer Park Hospital, Singapore.
J Multidiscip Healthc. 2021 May 20;14:1149-1158. doi: 10.2147/JMDH.S307470. eCollection 2021.
Integration of distinct clinical perspectives in multi-disciplinary tumor board meetings is critical to determine optimal patient care. Digital tools can support the data consolidation needed for meeting preparation and data sharing during complex case reviews. In this paper, we assessed the value of a clinical decision support tool on workflow efficiency and conducting a complex case review of a dermatofibrosarcoma protuberans (DFSP) tumor.
Case presentation was performed by each unique clinical specialty that had relevant information about the patient; an oncologist, a pathologist, and a radiologist. Virtual discussion was completed online with case presentation and documentation with NAVIFY Tumor Board. Workflow efficiency assessment was done through interviews and observation of the # of steps across different team members involved in preparing and conducting cancer multidisciplinary team (MDT) meetings before and after the implementation of the NAVIFY Tumor Board solution.
Case review consisted of surgical and therapeutic intervention history, distinct histological and sequencing patterns representative of DFSP, with radiological review to determine areas for surgical intervention. Consolidation of clinical input led to a recommendation of a formal external hemipelvectomy with potential chemotherapy. Workflow assessment demonstrated a 46% total reduction in the # of steps for meeting preparation (from 69 to 37), with specific changes based on role: data manager (33 to 15), pathologist (26 to 13), radiologist (no change), and logistics (5 to 4). There was a 31% total reduction in the # of steps for conducting the meeting (from 51 to 35).
Utilizing a digital clinical decision support tool helped to consolidate patient data and improved case presentation through workflow efficiency. This allowed for improved interdisciplinary discussion on a complex DFSP case and supported the determination of a clinical decision.
在多学科肿瘤病例讨论会上整合不同的临床观点对于确定最佳患者护理方案至关重要。数字工具可以支持病例讨论准备所需的数据整合以及复杂病例审查期间的数据共享。在本文中，我们评估了一种临床决策支持工具对工作流程效率的价值，并对隆突性皮肤纤维肉瘤（DFSP）肿瘤进行了复杂病例审查。
由每个拥有患者相关信息的独特临床专业进行病例展示；一名肿瘤学家、一名病理学家和一名放射科医生。通过在线方式利用NAVIFY肿瘤病例讨论会进行虚拟讨论并进行病例展示和记录。通过访谈和观察在实施NAVIFY肿瘤病例讨论会解决方案前后参与准备和召开癌症多学科团队（MDT）会议的不同团队成员的步骤数量来进行工作流程效率评估。
病例审查包括手术和治疗干预史、DFSP特有的组织学和测序模式，并进行放射学审查以确定手术干预区域。综合临床意见后，建议进行正式的外侧半骨盆切除术并可能进行化疗。工作流程评估表明，会议准备步骤总数减少了46%（从69步降至37步），具体变化因角色而异：数据管理员（从33步降至15步）、病理学家（从26步降至13步）、放射科医生（无变化）和后勤人员（从5步降至4步）。会议召开步骤总数减少了31%（从51步降至35步）。
使用数字临床决策支持工具有助于整合患者数据，并通过提高工作流程效率改善病例展示。这有助于就复杂的DFSP病例进行更好的跨学科讨论，并支持临床决策的确定。
