Multidisciplinary Joint Clinics: Talent Wins Games, but Teamwork Wins Championships

Abstract

Cancer is among the leading causes of deaths worldwide. The treatments of cancer across most sites involve using surgery, systemic therapy, and radiation therapy. The treatment protocols are complex and require careful planning at the beginning of the therapy and coordination between the treating teams, the patient, and the caregivers to ensure compliance and avoid unnecessary treatment delays. This commentary provides an insight into the role the multidisciplinary joint clinics play in providing personalized cancer care. While such joint clinics are advantageous, they are not devoid of drawbacks and these are also enumerated. In this era, when communication platforms are increasingly digitized, we have highlighted the need for virtual tumor boards. The commentary aims to motivate the development of multidisciplinary joint clinics for ensuring holistic cancer care across the country.

Keywords

Holistic care - joint clinics - multidisciplinary care - personalized medicine - virtual tumor board

• References

• 1 World Health Organization. Globocan 2018: All Cancers. Int Agency Res Cancer 2019; 1: 1-2
• 2 Breast Cancer Survival Statistics Cancer Research UK. Available from: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer/survival#heading-Three. [Last accessed on 2020 Jan 20].
• 3 Agarwal G, Ramakant P. Breast cancer care in India: The current scenario and the challenges for the future. Breast Care (Basel) 2008; 3: 21-7
• 4 Nair N, Shet T, Parmar V, Havaldar R, Gupta S, Budrukkar A. et al. Breast cancer in a tertiary cancer center in India - An audit, with outcome analysis. Indian J Cancer 2018; 55: 16-22
• 5 National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Available from: https://www.nccn.org/professionals/physician_gls/default.aspx#site. [Last accessed on 2020 April 27]
• 6 Tinetti ME, Naik AD, Dodson JA. Moving from disease-centered to patient goals-directed care for patients with multiple chronic conditions: Patient value-based care. JAMA Cardiol 2016; 1: 9-10
• 7 Bajpai V. The Challenges Confronting Public Hospitals in India, Their Origins, and Possible Solutions. Adv Public Heal 2014 2014; 1: 27
• 8 Blackwood O, Deb R. Multidisciplinary team approach in breast cancer care: Benefits and challenges. Indian J Pathol Microbiol 2020; 63: S105-S112
• 9 Meguid C, Ryan CE, Edil BH, Schulick RD, Gajdos C, Boniface M. et al. Establishing a framework for building multidisciplinary programs. J Multidiscip Healthc 2015; 8: 519-26
• 10 Gupta T. Multidisciplinary clinics in oncology: The hidden pitfalls. J Oncol Pract 2007; 3: 72-3
• 11 Rosell L, Wihl J, Nilbert M, Malmström M. Health professionals' views on key enabling factors and barriers of national multidisciplinary team meetings in cancer care: A qualitative study. J Multidiscip Healthc 2020; 13: 179-86
• 12 O'Daniel M, Rosenstein AH. Professional communication and team collaboration. Patient Saf Qual An Evidence-Based Handb Nurs 2008; 2: 271-84
• 13 Busse R, Klazinga N, Panteli D, Quentin W. Health policy series No. 53 The Editors Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies. Denmark; 2019. http://www.healthobservatory.eu. [Last accessed on 2020 Apr 26].
• 14 Mental Health Commission. Multidisciplinary Team Working: From Theory to Practice; 2006. Available from: https://www.mhcirl.ie/File/discusspapmultiteam.pdf. [Last accessed on 2020 April 25].
• 15 National Cancer Grid. Virtual Tumour Board NCG. Available from: https://tmc.gov.in/ncg/index.php/activities-ncgvrtual-tumor-board. [Last accessed on 2020 Apr 26].
• 16 Aston SJ, Reade S, Petersen B, Ward C, Duffy A, Nsutebu E. et al. Extraordinary virtual multidisciplinary team meetings – A novel forum for the coordinated care of patients with complex conditions within a secondary care setting. Futur Healthc J 2018; 5: 218-23
• 17 Shea CM, Teal R, Haynes-Maslow L, McIntyre M, Weiner BJ, Wheeler SB. et al. Assessing the feasibility of a virtual tumor board program: A case study. J Healthc Manag 2014; 59: 177-93
• 18 India Against Cancer. Most Important Cancer Treatment Centers in India. Available from: http://cancerindia.org.in/cancer-treatment-centers/. [Last accessed on 2020 Mar 02; Last accessed on 2020 Apr 26].
• 19 Hammer RD, Prime MS. A clinician's perspective on co-developing and co-implementing a digital tumor board solution [published online ahead of print, 2020 Jan 23]. Health Informatics J 2020;1460458219899841.
• 20 Nair N, Gupta S, Ramarajan N, Srivastava G, Parmar V, Munshi A. et al. Validation of a software based clinical decision support system for breast cancer treatment in a tertiary care cancer center in India [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-16-01
• 21 Vora T, Khanna N, Prasad M, Ramarajan N, Srivastava G, Bhat V, Qureshi S. et al. Prospective comparison of travel burden, cost and time to obtain pediatric multidisciplinary tumor board treatment plan through in-person visits vs an AI enabled health technology. Pediatr Blood Cancer 2019; 66: e27989
• 22 Acai A, Sonnadara RR, O'Neill TA. Getting with the times: A narrative review of the literature on group decision making in virtual environments and implications for promotions committees. Perspect Med Educ 2018; 7: 147-55