The joined-up approach: how integrated, digital MDT meetings can deliver for integrated care services, providers and patients

November 2, 2022

The joined-up approach: how integrated, digital MDT meetings can deliver for integrated care services, providers and patients

November 2, 2022

Multi-disciplinary team meetings are not new, but they are growing in importance, so they need to be run efficiently and effectively. That means using integrated, digital technology, to streamline administration, provide a better experience for those attending, and share decisions with the wider care team, a Parsek webinar heard.

Multi-disciplinary team meetings are not new: but with the development of cancer and other disease networks, and the arrival of integrated care systems with their remit to join-up health and care services, they are growing in importance.

This has created a renewed imperative to make sure MDT meetings are run as efficiently and effectively as possible. Integrated digital technology can streamline administration, provide a better experience for those attending, and share decisions with the clinical team.

A Parsek webinar explored how the Vitaly platform and collaborative decision-making application can support these objectives.

 

Integrated care needs integrated data  

Professor Graham Evans, executive Chief Digital and Information Officer at NENC Integrated Care Board (ICB), started by setting the scene. “Demand,” he pointed out, is “going up practically by the hour” and emergency and hospital services are struggling to cope amid financial constraints.

Yet that demand being driven by a mix of ageing, inequality, and long-term conditions some of which, at least, could be avoided. “So,” he argued, “the NHS, and the health and care system more generally, needs to work differently: to break down traditional barriers between services and to move from fixing people who are broken to a more preventative way of working.”

The North East and North Cumbria integrated care system has drawn up nine priorities for moving in this direction that are underpinned by technology and data. And MDT meetings will have a key role to play. “MDT meetings are not a new idea, but they are, perhaps, a new idea for solving some of the problems we have,” Professor Evans said.

“We want to provide data not just to one clinician but to teams of clinicians so that we can direct patients to the most appropriate part of the system. We are moving from an era of competition to an era of collaboration, and for that to work, we need people to work in multi-disciplinary teams for the good of our populations.”

 

Using Vitaly to support child health in the UK  

Dr Chris Gardner, a Consultant Paediatrician and Deputy Medical Director at East Lancashire Hospitals NHS Trust told at the webinar that MDT meetings are certainly not a new thing in his area of medicine. “Paediatricians have always been MDT people,” he said. “We work with school nurses, community practitioners, GPs…”

“But as we have got busier, being able to manage the MDT, to get MDT meetings together, is more and more challenging…, particularly in an area like East Lancashire, where there are some very long journey times.”

Holding meetings virtually helps, but Dr Gardner said there were significant challenges to do this without a data integration platform or dedicated workflow. Administrators spent a lot of time chasing up information, clinicians rarely had the chance to review notes or results ahead of the meeting, and there was no way to easily record the outcomes.

“A lot of the meeting could be spent just trying to get the information together,” he said. The area is implementing the Vitaly solution, integrated with the WeLPRES shared care record, to address this.

“We have been able to introduce a single system that allows us to generate referrals, from whichever member of the MDT wants to bring forward cases, to share relevant information,” Dr Gardner explained. “It even syncs nicely into a patient portal that we have developed to enable parents to share information, such as video information.

“And we are able to record the outcomes of our meetings and enable them to be shared into the shared care record, so we have full visibility for all members of the MDT.”

 

Using Vitaly to support oncology MDTs in The Netherlands  

The network approach to delivering cancer care is already well-established in the Netherlands. Patients are referred to different centres according to their tumour type and their requirement for surgery, radiotherapy or drug therapy.

Arjo Boendermaker, a healthcare consultant and the Project lead of Data-Sharing Central Netherlands (DDMN), said this has raised the importance of the MDT meetings that make diagnosis and treatment decisions. Yet, as in the UK, the lack of interoperability between hospital electronic medical records makes it difficult to get the necessary reports, images and results together.

Boendermaker is working with six hospitals in the central Netherlands that have implemented an Open Line cloud-based architecture to automate the exchange of data across the region, and this is being integrated with the Vitaly collaborative decision-making solution to support MDT meetings.

Even without the integration, he said the results of using the Vitaly solution have been impressive. There has been “a substantial reduction in the administrative burden of MDT meetings”, fewer delays in getting patient cases into case conferences, fewer re-discussions, and more “right care delivered in the right place.”

“We have been running the pilot of Vitaly for over three years now, and we have never stopped running the pilot, because medical professionals are very happy with it,” he said.

“We are just adding integration with three EMRs and an image store at the moment, and [when that is live] we have several MDTs for different tumour types that want [to start using the platform] because they can see it improves care for patients.”

 

Integrated, web-based, flexible

To round out the event, Zan Virtnik, UK Market Lead at Parsek, outlined some of the key capabilities of the Vitaly solution for running effective MDTs beyond borders. He explained that everybody involved in an MDT meeting is given a role, which enables them to access relevant data and workflow streams.

For example, he said, in the requesting phase, all members of the MDT can access relevant information from different electronic patient records and data repositories. Clinicians fill in a request form that can be adapted for different kinds of MDT to put forward a case for discussion.

In the next step, a ‘scheduler’ or ‘gatekeeper’ reviews the request and makes sure it is ready to be scheduled. After which, there is a preparation phase, during which all members of the MDT can review the information provided and communicate with each other.

Virtnik explained that this “helps them to collaborate together and speed up the decision-making process”; leaving more time for the discussion of complex cases.

On the day of the meeting, the ‘board conference’ can be integrated with a video conferencing platform, so participants can attend remotely. The chair moves from one case to another, and a report is automatically compiled for sign-off and distribution to EPR systems.

“By using Vitaly’s collaborative decision-making approach, healthcare providers can reduce administration and improve time management and user experience,” he said. “Integrated care systems can increase productivity and reduce costs by introducing automated workflows and reducing regional differences in the quality of patient care.

“Last, but not least, you can improve outcomes for patients by reducing the number of cancelled cases and offering more equal quality of care across the region.”

Watch the webinar: Webinar attendees were keen to know more about the integration capabilities of the Vitaly solution, about information governance and about specific roles – such as the ‘gatekeeper’. Participants also discussed how building a ‘strategic’ solution can support deployment to more teams and adding new specialities. You can watch the full webinar here.  

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