VICS Optimal Care Summits lung cancer consultation 2014

The first lung cancer consultation in the VICS Optimal Care Summits program (then called the Victorian Tumour Summits) was held in 2014.

The live summit event on 14 November 2014 brought together 60 multidisciplinary clinicians providing care to lung cancer patients across Victoria. The participants identified more than 20 opportunities for improvement in lung cancer care within Victoria. Following further consultations with stakeholders, the expert advisory group below presented the following recommendations.

Recommendations

1. Allocate funding for statewide projects to evaluate and optimise the timeliness of lung cancer care from referral to diagnosis to treatment
2. Further investigate possible reasons for variation between Integrated Cancer Services in rates of tissue diagnosis for lung cancers and adjuvant chemotherapy in non-small-cell lung cancer (NSCLC)
3. Agree upon features of an exemplar lung cancer multidisciplinary meeting (MDM) and implement them in all Victorian lung cancer MDMs
4. Form an advisory group of lung clinical champions to support statewide implementation of the 3 recommendations above
5. Routinely communicate MDM recommendations to GPs in a timely manner
6. Development, led by the Cancer Council Victoria Clinical Networks (CCV-CN), of a reportable indicator for access to palliative care for lung cancer patients
7. Formalise links between health services with limited access to tests and expertise for prompt diagnostic work-up of lung cancer cases and their closest tertiary lung health services
8. Scoping, by the VICS of lung cancer patients’ access to allied health – then recommend appropriate statewide or local action
9. A campaign by organisations such as the Clinical Oncology Society of Australia (COSA), Cancer Council Victoria, and the Medical Oncology Group of Australia MOGA, advocating for re-interpretation of the ‘10 minute rule’ for MBS billing of MDM cases
10. Include a communication about Epidermal Growth Factor Receptor (EGFR) mutation testing in the official newsletter of the Royal College of Pathologists of Australasia (RCPA)
11. Review the purpose of the existing Cancer MDM Directory to inform its future use
12. The VICS to pursue a common statewide MDM software solution for implementation at all Victorian cancer MDMs
13. Evaluation by the Cancer Council Victoria Clinical Networks (CCV-CN) of the efficacy and marketing of the Clinical Trials Link
14. Communicate updates on current statewide projects relevant to lung cancer care to the broader Victorian lung cancer MDM membership
15. Implement strategies to facilitate sharing of information and ideas between Victorian lung cancer MDMs.

Recommendation 12 above led to the development and implementation of the QOOL-Vic (Queensland Oncology On-Line – Victoria) multidisciplinary meeting software platform.

Also after the 2014 lung cancer summit, the Victorian Lung Cancer Service Redesign Program was created to assist hospitals in developing systems and measures targeting improvements in timeliness of lung cancer care from stages 2 (referral) to 4 (begin treatment) of the Optimal Care Pathway. The following improvements from baseline (September 2016 – February 2017) were seen in the post-intervention period (March–August 2017):

• 9% increase in patients getting a first specialist appointment within 14 days of referral
• 6% increase in the proportion of patients presented to a multidisciplinary meeting
• 5% increase in those receiving chemotherapy within 14 days of diagnosis
• 3% increase in the proportion of patients with a documented supportive care screening tool
• decrease of 2 median days in the time from referral to the first specialist appointment
• decrease of 3.5 median days in the time from diagnosis to the first chemotherapy treatment
• decrease of 2 median days in the time from diagnosis to the first radiotherapy treatment.

Read the program’s final report here.

Progress following this summit was considered at a repeat lung cancer summit in 2019.

Summit records

• Opportunities for improvement identified in morning session (PDF)
• Opportunities for improvement and suggested actions identified in afternoon session (PDF)
• Data presentation (PDF)
• Recommendations (PDF)
• Summary report (PDF)

Expert advisory group

• Prof. David Ball (Chair) – Radiation oncologist, Peter MacCallum Cancer Centre
• Dr Andreas Baisch – Respiratory physician, Wangaratta Cardiology and Respiratory Centre
• Mr Andrew Barling – General and thoracic surgeon, Bendigo
• Dr Richard De Boer – Medical oncologist, Epworth Healthcare and Royal Women’s Hospital
• Dr Michael MacManus – Radiation oncologist, Peter MacCallum Cancer Centre
• Prof. Danielle Mazza – Head of Dept of General Practice, Monash University
• A/Prof. Paul Mitchell – Medical oncologist, Austin Health
• Dr Jeremy Ruben – Radiation oncologist, Alfred Health
• Dr Rob Stirling – Respiratory physician, Alfred Health
• Dr Gary Richardson – Medical oncologist, Cabrini Health
• Dr Craig Underhill – Medical oncologist, Border Medical Oncology
• Mr Gavin Wright – Cardiothoracic surgeon, St Vincent’s Hospital and Peter MacCallum Cancer Centre
• Dr Jackie Yoong – Medical oncologist, Northern Health.