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OneCommunity Tumor Boards Offer Virtual, Real-Time Expert Consensus

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OneOncology—a partnership of community oncology practices—launched a digital clinical communication platform in December 2019 that allows medical oncologists and other experts within the network to examine complex medical cases, offer input on real-time questions, share information and resources, and suggest ongoing clinical trials. “OneCommunity” was created to help physicians within the OneOncology network to keep pace with therapeutic and diagnostic innovation.

“One of the biggest challenges in oncology, and specifically medical oncology, is the rapid pace of development and the standard-of-care changes happening practically overnight,” said Stephen Schleicher, MD, MBA, medical director of value-based care at Tennessee Oncology, a OneOncology practice, in an interview with Journal of Clinical Pathways.

A key component of OneCommunity is the virtual tumor boards. The platform provides network members the opportunity to share the details of a complex patient case with other disease-specific experts or experienced physicians. The tumor boards are particularly useful for individual patient cases for which published evidence on optimal treatment approaches is either conflicting or lacking.

“OneCommunity tumor boards typically deal with treatment management issues for complicated patient cases rather than imaging or findings on a mammogram or a CT scan,” stated Lee Schwartzberg, MD, FACP, West Cancer Center, and chief medical officer, OneOncology, in an interview with Journal of Clinical Pathways. “These cases allow multiple individuals to weigh in on their approach to ‘gray areas’ where the evidence base is scant or absent.”

OneCommunity Tumor Board Design

The tumor board is designed like a “provider-facing social media platform,” noted Dr Schwartzberg, and content-heavy with clinical aspects of care. Many features of the platform are comparable to popular social media platforms in order to encourage ease-of-use and participation. Users are not only able to post details of their own patient cases, but also comment on the cases of their peers. Comments can be “liked” or debated. Furthermore, users can “tag” specific colleagues within the network in a comment and send private “direct messages” to other users. The goal of these tumor boards is to help build consensus in real time for difficult cases and foster a continuous knowledge base within the network to inform treatment decisions.

For physicians trying to post a complex patient case on the platform, they first navigate disease-specific categories in which to post (ie, melanoma, lung, or breast). Physicians are prompted to provide a paragraph or more detailing the case and then pose a question about treatment decisions. The “tumor board” is then published on the platform. Users are able to log-on to the platform, comment with their professional expertise, provide links to published studies relevant to the case, and share evidence that supports their points of view.

“When a new case is posted, there is almost always comments posted within the same day from several different experts,” said Dr Schwartzberg.

“Traditional tumor boards may meet monthly or even less frequently,” Dr Schleicher echoed. “With OneCommunity tumor boards, physicians get answers to challenging patient cases in close to real time – perhaps in 24 to 48 hours.”

Other topics that have been addressed on the platform include a debate on the value of proton therapy, how to improve community health, and how to improve lung cancer screening efforts.

Further Direction for Refinement

In the coming weeks, OneOncology plans to archive tumor board cases based on disease type as well as develop a search function for users in order to allow for more efficient maneuvering across the platform. Additionally, users will be able to configure their OneCommunity profiles to receive only the tumor board cases that pertains to their specialties or interests.

Furthermore, OneOncology plans to design a molecular hybrid model tumor board that is similar to a traditional multidisciplinary tumor board. This platform will not only accept patient case summaries, but also accept diagnostic and pathology images. Also in development is a subsite for advanced practice providers to discuss issues relating to them specifically.

“It is still early, but the level of participation the tumor boards have received leads us to believe that we have found a solution to enhance communication across a large community oncology network,” posited Dr Schwartzberg. “On some cases, we have 5000 to 6000 views, which is a very good sign.”

Dr Schleicher noted the challenge of new practices joining the OneOncology network and having to re-engage the on-boarded physicians in the platform. “New physicians and practices joining our network is a huge opportunity of the educational benefit of this initiative because we want as many diverse opinions as possible contributing to the tumor boards, but we have to start the engagement process all over again each time a new practice joins the network. It will continue to be a challenge to focus on for the foreseeable future.”—Zachary Bessette