Clinical Utility of Integrated Multidisciplinary Patient-Centered Information in Breast Cancer Care: A Mixed Methods Study

Atsuko Sugiyama,1– 3 Kazuki Utsunomiya,1 Katsuhiko Fujimoto,1 Hiroko Bando4 1R&D Planning Office, Canon Medical Systems Corporation, Otawara, Tochigi, Japan; 2Research and Development Center, Canon Medical Systems Corporation, Otawara, Tochigi, Japan; 3Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, Japan; 4Department of Breast-Thyroid-Endocrine Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, JapanCorrespondence: Atsuko Sugiyama, R&D Planning Office, Canon Medical Systems Corporation, 1385, Shimoishigami, Otawara-shi, Tochigi-ken, 324-8550, Japan, Tel +81 287 26 6255, Fax +81 287 26 6066, Email [email protected]: The purpose of this study was to evaluate and assess the clinical utility of the integrated multidisciplinary patient-centered information (PCI) written by various healthcare professionals for promoting patient-centered care in the treatment and care of breast cancer patients.Methods: This study employed a convergent mixed methods interventional design in which Control and Intervention were compared by integrating both quantitative and qualitative results obtained from questionnaires and verbatim transcripts. In three breast cancer cases, a multidisciplinary team meeting (MDTM) using a conventional electronic health record (EHR) viewer was designated Control, and a MDTM using a conventional EHR viewer plus the integrated multidisciplinary PCI was designated Intervention. Questionnaires, which consisted of questions about efficiency and patient-centeredness employing a 5-point Likert scale, were analyzed statistically using Wilcoxon rank test and summary statistics. Verbatim transcripts were analyzed using a thematic analysis hybrid approach.Results: Three surgical oncologists and three nurses (ward, outpatient chemotherapy, and palliative care) participated in the MDTMs for both Control and Intervention. The quantitative data suggested that there were statistically significant differences between Control and Intervention (p< 0.05), with Intervention superior to Control from the viewpoints of efficiency and patient-centeredness. The qualitative data suggested that the MDTM for Intervention involved more PCI and promoted shared understanding from early in the meeting. Synthesis of both the quantitative and qualitative results suggested that use of the integrated multidisciplinary PCI in MDTMs may facilitate the utilization of PCI and lead to more efficient and patient-centered discussions and decision-making to promote patient-centered care.Conclusion: Integrating the PCI obtained from medical records of various healthcare specialists already documented in the hospital information system could prove to be helpful for supporting MDTMs and routine clinical practice without placing an additional burden on busy healthcare professionals while also promoting the digital transformation of healthcare.Keywords: breast cancer multidisciplinary team, patient-centered care, patient preferences, psychosocial information