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Multidisciplinary Cancer Conferences Frequently Asked Questions

Multidisciplinary Cancer Conferences (MCCs) ensure that appropriate tests and the most appropriate treatment options are generated for each cancer patient discussed in a multidisciplinary forum. The following information answers questions healthcare providers commonly ask about these conferences.

Are Multidisciplinary Cancer Conferences used in other countries?

Yes. Internationally, the term for these meetings will differ. You may see the following terms used, signifying a similar type of meeting: Tumour Board, Multidisciplinary Team Meetings, etc. Alternatively, these terms may signify a meeting with a different purpose. The key defining factors with Ontario Multidisciplinary Cancer Conferences is that it is a regularly scheduled meeting (at least twice per month) that discusses cases prospectively in a multidisciplinary format.

The United States, United Kingdom and Australia have been using multidisciplinary forums for many years, which are considered the typical standard of care. Singapore and other parts of Canada use this method as well. Italy, Pakistan and Austria have also shown interest in MCCs.

What are some of the problems I might face starting a Multidisciplinary Cancer Conference and how can I overcome them?

Barriers can be encountered when starting up Multidisciplinary Cancer Conferences (MCC). Hospitals interested in starting up MCCs should consider these challenges; however, many of these challenges have solutions. A list of MCC barriers and enablers is provided below.

BARRIERS ENABLERS
Lack of funding or participation payment
  • Cancer Care Ontario has provided each region dedicated funding for MCC coordination and regional implementation.
  • In 2011 an Ontario Health Insurance Plan billing code was approved for many disciplines participating and for MCC Chairs.
Legal and liability concerns
Perceived as “Just another meeting”
  • Identify local champions to drive change and gain support.
  •  Educate on the value of the multidisciplinary discussion for the patients and identifying system changes.
  • Get started with those who are interested.
  • Identify a strong MCC chair to facilitate effective discussion.
  • Appoint a dedicated MCC coordinator (considered the glue that makes the MCC possible).
  • Optimize technology and offer training for ease of use.

Finding the right time for everyone to attend

  • Make sure there is a consistent regular time and date.
  • Groups of radiologists and pathologists have developed a scheduling roster to share participation amongst members.
  • Partner via videoconferencing with another hospital that offers a specific disease site MCC.
Lack of understanding about MCC benefit

There are many ancillary benefits:

  • Smaller hospitals have immediate access to broader range of expertise.
  • Referral pathways are more likely to be streamlined. · Opportunity exists for MCC members to earn Professional Education Credits.
  • Greater collegiality and understanding develops within and between disciplines.
  • Most discussion that takes place during the meeting reduces the need for phone calls at other times.
  • Increases occur in clinical innovation, research and participation in clinical trials.

 

Can physicians obtain Royal College Credits for participating in Multidisciplinary Cancer Conferences? If so, how is this done?

Yes, physicians can obtain Maintenance of Certification (MOC) credits for participating in Multidisciplinary Cancer Conferences (MCCs).

Participants may accumulate MOC Program Section 1 credits for their participation in both accredited and unaccredited MCCs, however the number of credits that can be earned is different for the 2 types of MCCs. Presenters, such as pathologists or radiologists may accumulate MOC Program Section 2: Personal Learning Project credits for their preparation time for MCCs.

An attendance record should be maintained by the MCC coordinator and distributed annually to participants in order for them to log the proper hours accumulated.

For details on MCCs and accreditation, download the MCC Accreditation Information Package (toolkit) for Continuing Professional Development.

For further information, please visit the Royal College of Physicians and Surgeons website.

How do I get more information on videoconferencing for my hospital?

The Ontario Telemedicine Network helps deliver clinical care and professional education among healthcare providers and patients. This is accomplished by using telecommunication technologies such as two-way videoconferencing systems and tele- diagnostic instruments such as digital stethoscopes, otoscopes and patient examination cameras. Access to and the proper functioning of this equipment is essential for having Multidisciplinary Cancer Conferences via video conference.

Regional Ontario Telemedicine Network managers can:

  • arrange for an assessment of your meeting space and equipment required for videoconferencing
  • inform you of education and training opportunities
  • assist with questions and concerns, and direct troubleshooting issues

To find out more about the Ontario Telemedicine Network and how to contact your regional manager, call: 1-866-454-OTN1 (6861).

Can I log in to Multidisciplinary Cancer Conferences through my personal computer?

Yes. The Ontario Telemedicine Network has developed secure software that allows a person to videoconference into a Multidisciplinary Cancer Conference from their desktop or laptop (Mac or PC). This allows physicians to join a conference from their home or office.

Please visit the Ontario Telemedicine Network website for more information about personal computer videoconferencing.

Why would the Multidisciplinary Cancer Conference need a database? What benefits would it offer?

Electronically capturing patient summaries (e.g., patient electronic chart) and results over time can offer a wealth of potential benefits:

  • gain ideas for research that can be investigated further
  • measure success of patient outcomes
  • consider patient management protocols in place
  • measure adherence of Multidisciplinary Cancer Conference (MCC) recommendations to actual treatment received
  • assess changes in the treatment plan resulting from MCC discussion
  • measure MCC goals (clinical trial participation, etc.)

To make sure you receive the expected results, consider what specific information needs to be collected to capitalize on the desired benefits of the database.

  • What specific information about each case should be captured from the MCC?
    • birth date
    • medical record
    • tests completed
    • test results
    • diagnosis
    • other pertinent information the MCC reviewed
    • MCC treatment recommendation o other
  • What specific information about each case should be captured during treatment or after the patient receives treatment?
    • Does the actual treatment received differ from the treatment plan discussed at the MCC?
    • If different, what was different?
    • Why was the actual treatment different?
    • How did the patient respond to treatment?
    • Other

Finally, determine how and when information is going to be captured and who is going to be responsible for the information capture.

The preferred option will be the easiest one that meets all requirements. It may be best to brainstorm the best possible method within your site. Remember that patient confidentiality must be maintained.

Several Multidisciplinary Cancer Conference documentation tools offer helpful advice to adapt documentation processes.

How do you handle urgent cases between Multidisciplinary Cancer Conference meetings?

If an urgent case needs to be discussed in an Multidisciplinary Cancer Conference (MCC) forum, but cannot wait for the regularly scheduled meeting, a backup option such as an email discussion among the MCC members can be used so timely patient care will not be compromised.

This can be easily facilitated by composing an email distribution list of MCC members. This should be maintained by the MCC coordinator to make sure the list is up to date. Ensure that patient information transmitted is anonymous.

The subject line should quickly identify the purpose and time sensitivity of the email response (e.g., subject line: Urgent MCC Case Review).

If there is a high volume of urgent cases between MCC meetings, it may be necessary to review the frequency of the meetings.

We do not have a key member (e.g., medical oncologist, radiation oncology) in our region to attend a Multidisciplinary Cancer Conference. Does that mean we cannot have one?

With the use of videoconferencing, it may be possible to have a required discipline from another region provide expertise by attending your Multidisciplinary Cancer Conference (or vice versa).

Please contact your regional vice-president (RVP) or regional MCC coordinator to communicate these needs. They should be able to further discuss how filling this gap is possible.

How do I find out who my regional MCC coordinator is?

Each region has a dedicated MCC coordinator. To find out who the coordinator is for your particular region please contact the MCC Project Team at MCCinfo@cancercare.on.ca.