Expanding collaborations and regional networking among healthcare providers is an important source of progress. The nationwide initiative called ‘Regional oncology networks’ that is funded by Citrienfonds aims to establish regional collaborative networks for specific cancer types in order to offer the best available treatment to patients.

A successful example of expanded networking has been the formation of an online multidisciplinary triage panel in neuro-oncology, initiated by neurologist Dr. Tjeerd Postma, Dr. Mathilde Kouwenhoven and neurosurgeon Prof. Philip de Witt Hamer, Amsterdam UMC. The idea for the panel was based on the expert panel for colorectal liver metastases set up earlier by medical doctor and PhD student Tessa Hellingman, surgeons Babs Zonderhuis and Prof. dr. Geert Kazemier, also part of the Citrienfonds initiative.

In medical terms, triage means to quickly assess a medical condition to decide the urgency of treatment. The neuro-oncology panel aims to optimize the referral process for newly diagnosed patients with suspicion of brain cancer. “For some patients with a brain tumor, the sooner treatment can start the better,” says neurologist dr. Maaike Schuur. “A fast and appropriate referral could also reduce emotional distress for cancer patients.” Medical doctor and PhD student Merijn de Swart further explains the importance of timely referral: “Our experience shows that consideration by the neuro-oncology triage panel results in more patient-tailored referrals and reduced lead times to treatment, without increasing the costs and required time of health care professionals.”

The triage panel is composed of over 20 experts, neurologists, neurosurgeons, radiologists and radiation oncologists. Seven regional hospitals are affiliated with the triage panel and can digitally refer patients with the suspicion of a brain tumor. The panelists meet online 3 times a week to discuss shared medical imaging and treatment advice. Patients are then referred to the appropriate treatment facility after the meeting: either Amsterdam UMC outpatient clinics of neurology or neurosurgery, or a clinical transfer to Amsterdam UMC. In the study period between February 2019 and March 2020, the neuro-oncological triage panel has made recommendations for 72 patients with an average reduction of 13 days from time of initial diagnosis to treatment.

Neurologist Maaike Schuur: “Implementation of this online triage panel was feasible and beneficial in neuro-oncological care. We believe that this concept is promising, valuable and useful for other care processes that require the collaboration and coordination of multiple medical specialties as well. We aim to provide a helpful blueprint for implementation of a multidisciplinary triage panel.” 

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