Case Studies - regional cancer centres

Lack of access to a full MDC team in a remote area. Issues that were raised included:

• How would the new technology be accepted by clinicians involved in a teleconference?
• Would this create additional work or necessitate a change in practice which would compromise the establishment of a regular meeting?
• Could a convenient time be found and would the meeting participants see the benefit, which would encourage ongoing attendance?

Telehealth was presented as a solution. A ‘champion’ was identified at each end of the link who was committed to the process and who would encourage colleagues to attend. The telehealth link was added to a regular team meeting so that the meeting occurred in the telehealth room as standard practice regardless of whether a link by teleconference was planned. Pathologists and radiologists joining the teleconference were provided with images in advance of the meeting so that they could evaluate them before providing comment.

Regular meetings via teleconference.

See also: Case study: Setting up a multidisciplinary care team

The patient’s GP initiating a MDC meeting in a rural/regional setting.

To ensure the patient’s GP is involved in the MDC planning, cancer care coordinators were introduced to a rural/regional health service to provide the link between GPs and other specialists in the care team. The patient’s GP works closely with the patient’s care team and can initiate a care planning meeting by contacting the lead clinician. The GP is encouraged to attend the meetings in person or participate via teleconference.

Information presented by the GP about the patient’s history and psychosocial issues at the MDC planning meeting has influenced decision-making around treatment and care planning.

To Involve GPs in MDC discussion of breast cancer patients.

A representative GP from the local Division of General Practice attended the MDC meeting to represent all the patients’ GPs. This representative took on the role because of an interest in the area and is therefore knowledgeable medically and in regard to the specific care available in the community. The representative GP also liaised with individual GPs before the meeting to provide any useful GP perspective on the patient’s situation. After the meeting the GP’s role also included feeding back the meeting recommendations to each patient’s GP. This position is funded.

Attending the meeting is one GP’s regular commitment and is therefore readily achievable. Their involvement allows both input from a GP perspective, and appropriate and timely feedback to the patient’s GP.