Digital Tumor Board Solutions Have Significant Impact on Case Preparation

Abstract

Purpose: Multidisciplinary tumor boards (TBs) are the gold standard for decision-making in cancer care. Variability in preparation, conduction, and impact is widely reported. The benefit of digital technologies to support TBs is unknown. This study evaluated the impact of the NAVIFY Tumor Board solution (NTB) on TB preparation time across multiple user groups in 4 cancer categories: breast, GI, head and neck (ie, ear, nose, and throat, or ENT), and hematopathology.

Methods: This prospective study evaluated TB preparation time in multiple phases pre- and post-NTB implementation at an academic health care center. TB preparation times were recorded for multiple weeks using a digital time tracker.

Results: Preparation times for 59 breast, 61 GI, 36 ENT, and 71 hematopathology cancer TBs comparing a pre-NTB phase to 3 phases of NTB implementation were evaluated between February 2018 and July 2019. NTB resulted in significant reductions in overall preparation time (30%) across 3 TBs pre-NTB compared with the final post-NTB implementation phase. In the breast TB, NTB reduced overall preparation time by 28%, with a 76% decrease in standard deviation (SD). In the GI TB, a 23% reduction in average preparation time was observed for all users, with a 48% decrease in SD. In the ENT TB, a 33% reduction in average preparation time was observed for all users, with a 73% decrease in SD. The hematopathology TB, which was the cocreation partner and initial adopter of the solution, showed variable results.

Conclusion: This study showed a significant impact of a digital solution on time preparation for TBs across multiple users and different TBs, reflecting the generalizability of the NTB. Adoption of such a solution could improve the efficiency of TBs and have a direct economic impact on hospitals.

FIG 1.

(A) Study design showing detailed timeline of the phased rollout of NAVIFY Tumor Board (NTB) for all tumor boards (TBs). Weekly mean TB preparation time/case for (B) breast, (C) GI, (D) ear, nose, and throat (ENT), and (E) hematopathology across users. The standard curve shows a significant decrease in preparation time with the launch of phase 2 and an additional decrease with phase 4 for breast and a significant decrease between phase 1 and phase 4 for ENT. A marginal but not significant decrease was observed for GI. No significant changes were observed for hematopathology. The y-axis represents time (minutes [min]) taken for the nurse navigator to prepare for the TB. The x-axis represents the weeks when TBs were prepared. Blue dots represent the average preparation time in the corresponding week. Vertical lines delineate the week of the launch of the NTB application, after initial and stable integration, as indicated. Though the standard curve does not represent the best fit for the present data, it is included to aid in data interpretation. EMR, electronic medical record.

FIG 2.

Weekly mean breast tumor board (TB) preparation time for (A) nurse navigator, (B) pathology resident, and (C) radiology. The standard curve shows a significant decrease in preparation time with the launch of phase 2 and an additional decrease with phase 4 for all three groups. The y-axis represents time (minutes [min]) taken to prepare for the TB. The x-axis represents the weeks when TBs were prepared. Blue dots represent the average preparation time in the corresponding week. Vertical lines delineate the week of the launch of the NAVIFY Tumor Board (NTB) application, after initial and stable integration as indicated. Though the standard curve does not represent the best fit for the present data, it is included to aid in data interpretation. EMR, electronic medical record.

FIG 3.

Weekly mean ear, nose, and throat (ENT) tumor board (TB) preparation for (A) nurse navigator, (B) pathology resident, and (C) radiologist. The standard curve shows a significant decrease in preparation time in phase 4 compared with phase 1 for pathology resident and radiologist. The y-axis represents time (minutes [min]) taken to prepare for the TB. The x-axis represents the weeks when TBs were prepared. Blue dots represent the average preparation time in the corresponding week. Vertical lines delineate the week of the NAVIFY Tumor Board (NTB) application launch, after initial and stable integration as indicated. Note: Though the standard curve does not represent the best fit for the present data, it is included to aid in data interpretation.