March 30, 2021
March 30, 2021
Discussing patients with healthcare professionals from different disciplines and different hospitals simultaneously requires a structured approach and a well-oiled digital data exchange. In the Central Netherlands region, the regional multidisciplinary consultation for uro-oncology is supported by a digital MDO portal. How do you like that?
Peter-Paul Willemse is an oncological urologist at UMC Utrecht and chair of the regional multidisciplinary consultation for urological tumours. Every week, he and his colleagues from hospitals in the Oncomid oncology network discuss about 40 patients with tumours in the prostate, bladder, kidneys or testes.
“The big advantage of one regional MDO is that many healthcare professionals from several houses discuss their patients together at the same time,” says Willemse. “Previously, there were small MDOs that another colleague and I from the UMC joined. Then the two of us sat with a group of healthcare professionals from one hospital. For two and a half years, we have had regional multidisciplinary consultations, and we are looking at a case with many more healthcare professionals beyond the walls of the hospitals.” An enrichment, he thinks: “The more people watch critically, the better we can make a decision to arrive at the best treatment advice for the patient.”
Good practice
A regional MDO cannot do without a reliable and secure digital exchange of patient data. After all, all participating healthcare professionals must have access to the same up-to-date information at the same time. An external platform, the so-called MDO portal, supports the regional MDO process and makes it possible to share data from the various hospital EPDs. A pilot for an MDO portal for uro-oncology has been running in the Central Netherlands region for a year now. The Oncomid hospitals Meander Medisch Centrum, Tergooi and UMC Utrecht participate in this pilot, which falls under the theme of Digital exchange of the Citrine program Towards regional oncology networks. The Antoni van Leeuwenhoek has also joined this.
“With this pilot, we are developing a good practice for an MDO portal for the discussion of patients with urological tumours,” says Jolanda van Blaaderen, product owner Connected Care at UMC Utrecht and involved in the Digital exchange of Towards regional oncology networks theme. “The experiences we gain with this are also valuable for the other regions. They can benefit from what we develop and learn. We also interact with each other as much as possible so that we don’t have to reinvent the wheel every time. In this way, we stimulate the digital exchange in the oncology networks across the country.”
Structured and fast
Willemse explains how it works: “The specialist registers a patient in advance for the multidisciplinary consultation. He makes the most up-to-date patient data available via the MDO portal so that all participants can prepare for the consultation. That way, you can quickly and in a very structured way arrive at the right treatment advice.” Speed is essential, he says: “We aim to discuss patients in the MDO within a week of being diagnosed. The treatment advice is immediately recorded and approved in the system and is directly sent to the doctor. The Federation of Medical Specialists and the Dutch College of General Practitioners have also agreed on this: important information must reach the doctor within 24 hours. Patients need a consultation with their GP. So they must be aware of our advice and the reasons for doing so very quickly. So that she can properly inform and support the patient in making his choice. “
MDO redesigned
At present, the EPDs of the participating hospitals are not fully integrated with the MDO portal. This means that healthcare professionals still retrieve some patient data, such as examination results, from their EPD and manually enter, check and send. Conversely, the MDO report and any references are also manually entered in the own EPD. When the link with the digital highway XDS has been established, and the portal is further integrated with its own EPD, this data exchange will automatically occur.
“There will be an update to the portal sometime in the first quarter of next year. We hope that there will be a connection,” says Willemse, who has been closely involved in the development of the MDO portal from the start. He explains that this initially took quite some effort: “It was redundant for us: we were going to work together in one regional MDO, and use this digital portal. We have redesigned the MDO to discuss patients regionally; people had to master that first. An example: you have to organize it in a way that the right specialist is present at an MDO at the right time. You cannot leave a radiologist who reports images and has nothing to do with patients from other hospitals for an hour without his contribution. His time is too precious for that.”
Willemse and his colleagues also encountered IT issues in particular: “Information that was missing, images that were not clearly visible, an unstable connection, unintelligible people. That has improved, as has the ease of use of the portal. That makes it less of a hassle for us to work with it.”
Better referral
In addition to the regional MDO, Oncomid is strongly committed to further regional cooperation with network tumour groups. There are twelve cross-hospital tumour groups, including those for each of the four urological tumour types. “These network tumour groups talk specifically about that tumour type and what you can best do in terms of treatment,” says Willemse. “Because treatments evolve, diagnostics and treatment options change, new scientific insights are emerging. The network tumour groups are looking at this and adapting the guidelines and advice for our region.”
More and more treatment is being done regionally instead of per hospital, says Willemse: “Patients come to UMC Utrecht for bladder removal, prostate surgery is only done at Meander MC. It therefore depends on the treatment to which the patient is sent from the MDO. And if there is a scientific study in one of the hospitals in which a patient can and wants to participate, we can easily refer him to it.”
Quality circle
“How can we extract data about our care from the system and use it for our own quality control; that is an important next step,” says Willemse. “We want to know whether our turnaround times and treatments correspond to the national standard. Are the complications the same, is the operating time correct, and are the diagnostics comparable? We then have our own quality control system on the basis of which we can adjust our MDO. The circle is then complete.”
Translated from the original source:
https://www.oncologienetwerken.nl/nieuws/artikel/mdo-portaal-samen-sneller-tot-beste-behandeladvies-komen
Want to know more about the MDO solution from the article? Check our reference case: https://parsek.com/references/umc-utrecht-regional-virtual-tumor-board