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W. Tellis



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    P3.24 - Poster Session 3 - Supportive Care (ID 160)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P3.24-022 - A Novel Web-Based, Mobile-Device Enabled Clinical Collaboration Platform in Lung Cancer - Multidisciplinary Patient Evaluations Via Networking Technology (ID 1465)

      09:30 - 09:30  |  Author(s): W. Tellis

      • Abstract

      Background
      Background: Expenditures in the United States on health care have reached and estimated $2.5 trillion and cost control measures have become major features of the current health care reform debate in this country. An approach to reducing ballooning health care costs has been to focus on quality and uniformity of standards of care using health informatic technologies. We have designed and implemented a web- based clinician-to-clinician communication and collaboration platform that is mobile device enabled. The system permits asynchronous communication among clinicians in conjunction with robust sharing of the content of the Electronic Medical Record (EMR) including X-rays, digital histopathologic images and molecular diagnostics. Principle aims of the project incluided (1) documenting accurate diagnoses (2) appropriate consultation and input from specialty services (3) treatment plan optimization spanning disciplines and (4) archiving the results of multidisciplinary decision making in a virtual environment.

      Methods
      Methods: Using Extensible Markup Language (XML) based system; a federal patient privacy regulation (HIPAA) compliant secure platform for communication was built according to specifications designated by clinicians in the Thoracic Oncology Section of UCSF Medical Center. The web based platform was approved by a committed on human research. The system was designed with integration of a Picture Archives Viewing System (PACS) and digitized pathology images to permit specific file upload, and annotation in a scalable manner allowing collaborations between two clinicians or among a group as large as 35. User group questionnaires and focus groups were performed to refine the computer-human interface and customize user experience. Members of the Thoracic Oncology Program (N=35) at the University of California at San Francisco were invited to participate in pilot study of the efficiency and ease of use of a novel web-based collaborative system for the purposes of an asynchronous “Virtual Tumor Board”.

      Results
      Results: A Trial of 50 patients had care plans coordinated via the virtual tumor board with input of the multi-disciplinary focus groups used in the development of the computer - human interface. 20% of clinicians related concerns over ease of use. 10% related concerns regarding excessive electronic messaging as a disruption of work flow. 15% voiced a main concern regarding clinician reimbursement for web based consultation. Of the cases presented on the virtual tumor board platform 100% achieved clinician consensus opinion with 5 days (mean 2.5 days). Patient Satisfaction assays suggested patient comfort with protected health information transfer on a secure platform. No adverse events were directly referable to system use.

      Conclusion
      Conclusion: A novel web based system for collaboration among clinicians holds the promise for reducing delays in optimized treatment planning and is regarded by clinicians as worthy approach to error reduction and reduction in delay to definitive treatment plan determination. Consensus opinions were rapidly obtained and archived records of discussion facilitates outcome reviews. Clinician concern included reimbursement patterns and efficiency but patient opinion was favorable toward this approach to collaborative decision making in oncology.