Over the past two years, the Data-Sharing Central Netherlands (DDMN) has been working towards a digital platform for the uro-oncology MDT meetings that is based on the Vitaly MDT solution.
The second oncology MDT use case is now also getting implemented. As chairman of regional MDT meetings and oncology urologist at UMC Utrecht, Peter-Paul Willemse was involved in the development of DDMN’s regional MDT infrastructure, which can now be rolled out to more MDT meetings.
We asked Peter-Paul Willemse some questions about his experience and involvement, which you can read below.
How is the uro-oncology MDT meeting set up? Which patient groups do you discuss?
“With all six hospitals in the region, we agreed to discuss every new oncology patient. Exceptions are low-grade tumours such as bladder tumours.”
“In addition, we discuss every patient with a recurrence or policy change. This is in line with the advice of the Soncos. At Oncomid, we have three hospitals presenting patients.”
Which specialists are at the table? How often do you meet?
“We do this sequentially because not only do the first-line specialists have to connect – in our case, the urologist, the oncologist, the radiotherapist – but also the radiologist, pathologist and nuclear medicine specialist have to be available.”
“This way, we can involve the other specialists in the MDT meeting as efficiently as possible: a list mixed up with groups we all discuss is less workable. If Vitaly allows it, in the next update, we would like to move more towards a preliminary meeting to introduce echeloning. That way, you can discuss and agree on less complex cases at once.”
Since when have you been working with the current version of the Vitaly platform?
“We have been working with the latest version since last Monday (3 April, ed.). The second MDT from another specialty will follow in a month’s time.”
“The pilot ran at the urology MDT meeting, but the platform has been running for two years and has already had two updates. Efficiency has been increased each time, the layout has been improved, so that you have a better overview and can get a good picture of the case in the three minutes you have per patient. Now it is also available that you can retrieve background information directly.”
Can you talk about what the going live of the new version of Vitaly means for the MDT meetings?
“The next version of Vitaly will allow all relevant information to be extracted directly from EHRs and put into the platform.”
What does Vitaly MDT solution mean for regional cooperation?
“Being able to discuss patients more efficiently also means you can have more specialists join the MDT meeting.“
“The more efficiently a patient is discussed, the shorter the entire MDT meeting takes. Before we used Vitaly, as a university hospital, we would first have an MDT meeting with one hospital and then with the next. If you do an MDT meeting for the entire region together, you also have to equalise all agreements and guidelines. A good MDT meeting ensures that the same standards and treatments are used and initiated regionally.”
What does it mean for the patient?
“It actually no longer matters which hospital a patient goes to. He or she gets the same diagnostics everywhere, the same treatment plan, and the advice is reviewed regionally. That supports regional quality standards.”
“Patient care is already so different now compared to 10 years ago. International and national guidelines are constantly changing (whenever it makes sense, not just once a year). When you work together in one MDT meeting in the region, you have all specialisations and areas of interest there.”
“We have subspecialty specialists who pick up and recite the updated guidelines so that they can be immediately incorporated into our regional protocols and working agreements. The care is so much more up to date and adapted to the latest knowledge and insights.”
Do you have any tips for other regional tumour working groups that will work with Vitaly in the future?
“Vitaly is now set up for oncology care standards. You can now use and complete it in such a way that you can grade patient cases and immediately implement treatment recommendations. My advice to new users is that they transfer their working agreements to the guidelines in Vitaly, so they can work with it in a very practical way.”
What have you contributed to the development/implementation of Vitaly’s new version?
“A number of issues, such as the ability to echelon, select and assign cases. I also advised on the layout and use of the platform during the MDT meeting work process.”
“Furthermore, I advised on medical applicability and necessities and possibilities within patient data transfer rules. In addition, I looked at clinical fit and ease of use during the MDT meeting. Finally, I named parameters and the importance of implementing a good quality cycle of the MDT platform.”