Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings
IntroductionNowadays nearly every patient with cancer is discussed in a multidisciplinary team meeting (MDTM) to determine an optimal treatment plan. The growth in the number of patients to be discussed is unsustainable. Streamlining and use of computerised clinical decision support systems (CCDSSs)...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1178165/full |
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| author | Janneke E. W. Walraven Janneke E. W. Walraven Rob H. A. Verhoeven Rob H. A. Verhoeven Jacobus J. M. van der Hoeven Renske van der Meulen Valery E. P. P. Lemmens Gijs Hesselink Ingrid M. E. Desar |
| author_facet | Janneke E. W. Walraven Janneke E. W. Walraven Rob H. A. Verhoeven Rob H. A. Verhoeven Jacobus J. M. van der Hoeven Renske van der Meulen Valery E. P. P. Lemmens Gijs Hesselink Ingrid M. E. Desar |
| author_sort | Janneke E. W. Walraven |
| collection | DOAJ |
| description | IntroductionNowadays nearly every patient with cancer is discussed in a multidisciplinary team meeting (MDTM) to determine an optimal treatment plan. The growth in the number of patients to be discussed is unsustainable. Streamlining and use of computerised clinical decision support systems (CCDSSs) are two major ways to restructure MDTMs. Streamlining is the process of selecting the patients who need to be discussed and in which type of MDTM. Using CCDSSs, patient data is automatically loaded into the minutes and a guideline-based treatment proposal is generated. We aimed to identify the pros and cons of streamlining and CCDSSs.MethodsSemi-structured interviews were conducted with Dutch MDTM participants. With purposive sampling we maximised variation in participants’ characteristics. Interview data were thematically analysed.ResultsThirty-five interviews were analysed. All interviewees agreed on the need to change the current MDTM workflow. Streamlining suggestions were thematised based on standard and complex cases and the location of the MDTM (i.e. local, regional or nationwide). Interviewees suggested easing the pressure on MDTMs by discussing standard cases briefly, not at all, or outside the MDTM with only two to three specialists. Complex cases should be discussed in tumour-type-specific regional MDTMs and highly complex cases by regional/nationwide expert teams. Categorizing patients as standard or complex was found to be the greatest challenge of streamlining. CCDSSs were recognised as promising, although none of the interviewees had made use of them. The assumed advantage was their capacity to generate protocolised treatment proposals based on automatically uploaded patient data, to unify treatment proposals and to facilitate research. However, they were thought to limit the freedom to deviate from the treatment advice.ConclusionTo make oncological MDTMs sustainable, methods of streamlining should be developed and introduced. Physicians still have doubts about the value of CCDSSs. |
| first_indexed | 2024-03-13T10:34:24Z |
| format | Article |
| id | doaj.art-d25c97675341408e84cb4a34c78e5973 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-13T10:34:24Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-d25c97675341408e84cb4a34c78e59732023-05-18T08:09:17ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11781651178165Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetingsJanneke E. W. Walraven0Janneke E. W. Walraven1Rob H. A. Verhoeven2Rob H. A. Verhoeven3Jacobus J. M. van der Hoeven4Renske van der Meulen5Valery E. P. P. Lemmens6Gijs Hesselink7Ingrid M. E. Desar8Department of Medical Oncology, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, NetherlandsDepartment of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, NetherlandsDepartment of Medical Oncology, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, NetherlandsDepartment of Medical Oncology, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Medical Oncology, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, NetherlandsDepartment of Intensive Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Medical Oncology, Radboud University Medical Center, Nijmegen, NetherlandsIntroductionNowadays nearly every patient with cancer is discussed in a multidisciplinary team meeting (MDTM) to determine an optimal treatment plan. The growth in the number of patients to be discussed is unsustainable. Streamlining and use of computerised clinical decision support systems (CCDSSs) are two major ways to restructure MDTMs. Streamlining is the process of selecting the patients who need to be discussed and in which type of MDTM. Using CCDSSs, patient data is automatically loaded into the minutes and a guideline-based treatment proposal is generated. We aimed to identify the pros and cons of streamlining and CCDSSs.MethodsSemi-structured interviews were conducted with Dutch MDTM participants. With purposive sampling we maximised variation in participants’ characteristics. Interview data were thematically analysed.ResultsThirty-five interviews were analysed. All interviewees agreed on the need to change the current MDTM workflow. Streamlining suggestions were thematised based on standard and complex cases and the location of the MDTM (i.e. local, regional or nationwide). Interviewees suggested easing the pressure on MDTMs by discussing standard cases briefly, not at all, or outside the MDTM with only two to three specialists. Complex cases should be discussed in tumour-type-specific regional MDTMs and highly complex cases by regional/nationwide expert teams. Categorizing patients as standard or complex was found to be the greatest challenge of streamlining. CCDSSs were recognised as promising, although none of the interviewees had made use of them. The assumed advantage was their capacity to generate protocolised treatment proposals based on automatically uploaded patient data, to unify treatment proposals and to facilitate research. However, they were thought to limit the freedom to deviate from the treatment advice.ConclusionTo make oncological MDTMs sustainable, methods of streamlining should be developed and introduced. Physicians still have doubts about the value of CCDSSs.https://www.frontiersin.org/articles/10.3389/fonc.2023.1178165/fullmultidisciplinary team meetingoncologystreamliningcomputerized clinical decision support systemsoncology care |
| spellingShingle | Janneke E. W. Walraven Janneke E. W. Walraven Rob H. A. Verhoeven Rob H. A. Verhoeven Jacobus J. M. van der Hoeven Renske van der Meulen Valery E. P. P. Lemmens Gijs Hesselink Ingrid M. E. Desar Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings Frontiers in Oncology multidisciplinary team meeting oncology streamlining computerized clinical decision support systems oncology care |
| title | Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings |
| title_full | Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings |
| title_fullStr | Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings |
| title_full_unstemmed | Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings |
| title_short | Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings |
| title_sort | pros and cons of streamlining and use of computerised clinical decision support systems to future proof oncological multidisciplinary team meetings |
| topic | multidisciplinary team meeting oncology streamlining computerized clinical decision support systems oncology care |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1178165/full |
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