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Feasibility Study: Early Experiences With a Cancer Center's Virtual Expert Medical Opinion Program
Allison Lipitz-Snyderman1, Susan Chimonas1, Brendan Raftery2
1Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
Purpose:
Second opinion consultations are a promising strategy to identify errors in diagnosis and recommend optimal treatment. Yet, there are geographic barriers. By bringing high-level care to patients where they live, virtual second opinion programs might benefit populations without access to specialty cancer centers. We conducted a feasibility study that examined changes in treatment recommended through a national virtual second opinion program based at a comprehensive cancer center.
Methods:
Memorial Sloan Kettering Cancer Center (MSK)'s virtual second opinion program was developed via a national cancer employer benefits solution. Each review was conducted by an MSK subspecialist and supported by a digital platform. After conducting the second opinion, subspecialists answered a questionnaire regarding their perceptions of the expected impact of recommended treatment changes. Here, we report findings from December 2023 to November 2024.
Results:
There were 231 cases completed. There were 55% women, with a median age of 56 years. Patients resided across the United States, with 56% from the South. The most common cancer categories were breast, GI and mixed tumor (GMT), and prostate. Cases were reviewed by 76 unique subspecialists. Subspecialists perceived that they made a meaningful change in recommended treatment (expected to affect patient outcomes) in 75 cases (32%). Expected changes included better prognosis/survival (n = 49, 65%), improved short-term morbidity/quality of life/toxicity (n = 36, 48%), or improved long-term morbidity/quality of life/toxicity (n = 49, 65%). There was a higher percent of recommended changes for liquid compared with solid tumor cases (liquid: 15 of 31, 48%; solid: 60 of 200, 30%).
Conclusion:
Findings are helpful for understanding the potential impact of a virtual second opinion program for patients with cancer and for developing strategies to reach underserved communities with geographic access barriers to high-quality cancer care from subspecialists.
