Enhancing Medical Committee Decision-Making: Insights from Qatar

Treatment Abroad (TA) programs are a key component of healthcare delivery for complex cases requiring highly specialized care. In Qatar, the International Medical Affairs Office (IMAO) manages over 11,000 TA requests annually through multidisciplinary committees and specialized subcommittees to support evidence-based decision-making. Despite advances in committee structures and the adoption of hybrid meeting models, challenges persist in optimizing efficiency, transparency, and committee member satisfaction, highlighting the need for systematic evaluation of committee processes and composition.

To identify challenges affecting decision-making and operational effectiveness within IMAO Treatment Abroad committees, define characteristics of optimal committee composition, and develop a reproducible framework to enhance transparency, communication, and committee practices across the IMAO and similar healthcare organizations.

Between July and December 2024, a cross-sectional survey was conducted among 162 CMs from main and specialized subcommittees using a home-developed instrument combining Likert-scale, yes/no, and open-ended questions; the tool was pilot-tested for reliability (Cronbach's α = 0.82). Quantitative data were analyzed using non-parametric tests, while qualitative data underwent dual-coded thematic analysis.

A total of 87/162 committee members (CMs) responded (53.7%), predominantly male (72.4%) and highly experienced within HMC (≥9 years, 86.2%), while 50.6% had similar experience within the IMAO committee. Most preferred remote or hybrid meetings (67.8%) and email communication (51.7%), with high satisfaction reported for workflows (93.1%) and IMAO collaboration (65-69%). While 81.6% reported no external influence on decisions, 23% identified the absence of subcommittee input as a barrier, and 52.9% supported anonymized patient requests to enhance transparency. Greater organizational experience was associated with higher satisfaction and increased perception of subcommittee absence as a barrier (36.4% vs. 9.3%; p < 0.05), whereas committee-specific experience showed no significant effect. Key challenges included communication gaps with overseas facilities, interface usability, incomplete medical information, lack of financial compensation (95.4%), and exposure to patient reprisals.

Medical committee effectiveness in Treatment Abroad programs is influenced by committee members' organizational experience and perceptions of decision-making processes. Findings underscore the need for structured multidisciplinary input, transparent governance, streamlined communication, and diverse committee representation across gender and experience levels to support equitable and consistent decision-making. The proposed hierarchical framework provides a practical model to standardize processes, enhance transparency, and optimize committee performance within IMAO and comparable healthcare settings.