by the concept creator, Professor Alastair Munro
The National Cancer Survivorship Initiative (NCSI) taught us a lot.
The following vignette gives some sense of what we learnt.
Imagine
that, a decade or so ago, you were diagnosed with cancer and treated with
surgery, radiotherapy and chemotherapy. You've been told by your doctors that
you are one of the fortunate ones: you have been cured of your disease. Your
clinicians are so confident of this that they have discharged you from their
clinics. Their job has been done.
The problem is, you don't feel lucky! You
have multiple symptoms affecting your bowels, your energy, your sexuality. You have
had to give up your job, your relationships are suffering and despite frequent
visits to your family doctor and several referrals to specialist clinics at the
local hospital, you feel that your problems are getting worse rather than
better. You seem, in terms of what the NHS has to offer, to have run into the
buffers.
The questions you might now be asking are: Is there really nothing
that can be done to relieve my symptoms? Who is out there who might help me? The
virtual MDT was set up in order to help patients find the answers to these
questions.
Why
multi-disciplinary team meeting? Why virtual? The problems faced by patients are
complex and no individual clinician has sufficient knowledge and experience to
be able to provide comprehensive management for such difficult problems: a
variety of disciplines and specialties are required. The multidisciplinary team
meeting offers the most effective and efficient mechanism for making the
necessary expertise available. The problem is that these experts are busy
people and particularly when it comes to highly specialised knowledge, geographically
dispersed. It is simply not possible to put them all in the same room at the
same time. However, if we use web-based software we can, without undue
difficulty, arrange virtual meetings in which contributors participate from
different places and at different times.
We tested the practicalities of this
concept using standard blogging software (WordPress) and this pilot study
showed that, once the usual problems of Internet access from NHS computers
could be dealt with, the system worked both in principle and in practice. It
was possible to assemble a virtual team of geographically dispersed experts and
the team was able, within 7 to 10 days of being asked a complex question, to
come up with a coherent plan for managing an individual patient's problems.
Macmillan Cancer Support have now taken the concept further. The vMDT uses
professionally developed software, running on secure servers compliant with all
NHS requirements concerning information governance and data protection. We have
assembled a highly experienced team who have agreed to share their expertise
and help to deal with individual patients’ problems entered into the system.
The
referral process is straightforward and offers patients, via their referring
clinicians, an opportunity to provide their own views on the nature and
severity of their difficulties. Our aim is to provide a service that deals with
the difficulties outlined in the introductory vignette.
Our hope is that
clinicians, in primary care and in hospitals, will feel able to embrace a
simple technology that offers hope and help to those who have been successfully
treated for cancer, but whose lives are marred by the late consequences of the
treatment that cured them.
For further information on the vMDT system, including referral criteria and FAQ's, please visit: www.macmillan.org.uk/vmdt
Further
Reading:
The
National Cancer Survivorship Initiative
What
is a virtual MDT?
