Abstract P5-14-04: Patient acceptance of multidisciplinary clinic and an app to communicate with their care team in breast cancer treatment
Authors: Farha MJ 
Published: May 2019

Abstract
Background: Interdisciplinary management improves the care of breast and other cancer treatments. Challenges to such coordinated care have been identified by The National Academy of Medicine (NAM):1-Poor collaboration among siloed physician 2- Poor patient education and involvement in a shared decision making environment. Multi D cancer conferences are a step in the right direction but true multi D clinics(MDC) with patients contemporaneously engaging their care team are rare. We initiated such clinic at our center and collected feedback information from our patients. We then helped design a HIPAA compliant mobile app, The Accord AppTM, to allow continued discussion centered around that patient's care and potentially including the patient in the discussion. We are reporting feedback from MDC and any available data on the Accord AppTMfeedback.
Methods: All new breast cancer patients attending our MDC were offered a survey seeking feedback regarding the whole clinic experience, their interaction with team members, clinic environment and the duration of this long consultation. Team members included breast surgery, medical and radiation oncology in addition to other services. Surveys were anonymous and non-obligatory. Surveys asked patients to grade different item on a 3 level scale: 1- Needs improvement 2- Met expectations 3- Exceeded expectations. The length of the consultation(LOC) was rated as: 1- Too short 2- Just right 3- Too long. The Accord AppTM was then developed as a HIPAA compliant tool that is being offered to patients and their care teams allowing ongoing discussion of patient care, sharing results and responding to patients' queries. Initial feedback from provider and patient users is being collected and will be reported.
Results: 67 consecutive surveys were prospectively collected and analyzed. The LOC mean score was 2.01. The other scores ranged from 2.49/3 for the physical environment to 2.87/3 for clarity of surgeon provided information. The overall experience was rated as 2.80/3. Feedback from Accord AppTM users is being collected.
Conclusions: Current collaboration tools including EMRs and Patient Portals have not resolved many of these teamwork and patient engagement issues reported by NAM. The MDC which frequently took over 2 hours was felt to be “just right“ to the vast majority of patients. Our patient mix is quite varied in age groups, levels of literacy, socioeconomic status and ethnicity and we experienced very little variability in that response. Patients rated their experience highly suggesting MDC to be a potentially valuable model for case discussions, cancer care team collaboration and patient engagement in a “shared decision“ environment. Initial feedback from the Accord AppTM seems promising and will be reported. More rigorous research into MDCs and mHealth tools such as the Accord AppTM is warranted to define and potentially expand their role in breast and other cancer care.
Citation Format: Farha MJ. Patient acceptance of multidisciplinary clinic and an app to communicate with their care team in breast cancer treatment [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-14-04.