Expanding Multidisciplinary Lung Conference in Rural/Regional North Carolina

November 2018 Vol 9, NO 11
Kimberly Cobb, RN, BSN
Chest Center of the Carolinas
FirstHealth of the Carolinas
Hope Gibson, RN
Scotland Cancer Treatment Center
Scotland Healthcare System

Background: Multidisciplinary care conferences for lung cancer patients have been linked to both increased quality of care and timeliness of care.1 The Chest Center Conference was established at FirstHealth Moore Regional Hospital in 2004 to encourage multidisciplinary discussion and to expedite treatment planning for patients with lung and esophageal cancer. Lung cancer patients who are treated at Scotland Cancer Treatment Center (SCTC) are frequently referred to Moore Regional Hospital pulmonology or thoracic surgery services for diagnosis and/or treatment. To improve the communication between hospitals, expanding the Chest Center Conference to SCTC via teleconferencing was proposed.

Objective: Ensure seamless comprehensive lung cancer care and an optimal patient experience by improving communication between providers at 2 community cancer centers.

Methods: To incorporate SCTC physicians/staff into Chest Center Conference discussions, our IT Department was contacted to establish videoconferencing via Webex. A projector was added that would focus on the screen, allowing the participants to view the imaging and pathology images in real time. A conference call was established at the beginning of each conference to allow for easy flow of conversations during the conference.

Our Health Information Management Department was consulted to ensure that HIPAA requirements were met. Anonymized conference summary sheets were faxed to Scotland Cancer Center prior to the start of the conference, and patients were referred to only by initials during discussion. Imaging was viewed without identifiers. The project was piloted in July 2016.

Results: A comparison of patients presented at Chest Center Conference in 2015 (514 patients) and 2017 (519 patients) did not show that video conferencing with SCTC affected patient volume. However, anecdotally, patient care was often expedited through the interdisciplinary approach.

Mr JG underwent 2 nondiagnostic bone biopsies. His films were reviewed by pulmonology, radiology, and pathology at multidisciplinary conference, and diagnostic thoracentesis with cell block for diagnosis and possible placement of pleural catheter for management of recurrent pleural effusion was recommended, alleviating an additional specialist consultation.

Mr BS was diagnosed with squamous cell lung cancer. A review at Chest Center Conference allowed for in-depth pulmonary evaluation to include lung perfusion scan, cardiopulmonary exercise testing, and cardiothoracic surgical evaluation. The patient was not a surgical candidate, but an expeditious evaluation allowed the patient to be treated earlier with combined-modality chemoradiation.

Conclusions: Ensuring that patients receive quality comprehensive lung cancer care is essential. Patients in rural and regional areas do not have easy access to larger, university-based cancer centers due to a myriad of factors. By expanding multidisciplinary lung cancer conferences to another institution in the same regional area, additional patients will receive the clinical benefit of a multidisciplinary approach.


Freeman RK, Ascioti AJ, Dake M, Mahidhara RS. The effects of a multidisciplinary care conference on the quality and cost of care for lung cancer patients. Ann Thorac Surg. 2015;100:1834-1838.

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