Original Contribution Establishment of a Regional Virtual Tumor Board Program to Improve the Process of Care for Patients With Hepatocellular Carcinoma

Purpose: Multidisciplinary evaluation (MDE) of hepatocellular cancer (HCC) is the current standard, often provided through a tumor board (TB) forum; this standard is limited by oncology workforce shortages and lack of a TB at every institution. Virtual TBs (VTBs) may help overcome these limitations. Our study aim was to assess the impact of a regional VTB on the MDE process for patients with HCC. Methods: A retrospective cohort studywas conducted, including patients with HCC referred to a tertiary cancer center from regional facilities (2009 to 2013). Baseline characteristics and outcomes were compared based on the referral mechanism: VTB versus sub-specialty consultation (non-VTB). The primary outcome was com-prehensive MDE (all required specialists present and key topics discussed). Secondary outcomes included timeliness of MDE and travel burden to complete MDE. Univariable andmultivariable logis-tic regressionswere performed to examine the association of a VTB with comprehensive MDE. Results: A total of 116 patients were included in the study; 48 (41.4%) were evaluated through the VTB. A higher proportion of VTB patients received comprehensive MDE (91.7 % v 64.7%; P .001); the VTB was independently associated with higher odds of accomplishing comprehensive MDE (odds ratio, 6.0; 95 % CI, 1.2 to 29.9; P .02). VTB patients completed MDE significantly faster (median, 23 v 39 days; P .001), with lower travel burden (median, 0 v 683 miles traveled; P .001). Conclusion: This VTB program positively affected the process of care for patients with HCC by improving the quality and time-liness of theMDE process, while avoiding the burden arising from travel needs. Future studies should focus on implementation of VTB programs on a wider scale