University of Missouri School of Medicine, Columbia, MO
Richard D. Hammer , Sharan Srinivas , Suchithra Rajendran , Chaohui Guo , Matthew Stewart Prime
Background: Multidisciplinary tumor boards (MTB) provide an interdisciplinary approach for decision-making in cancer care and are an integral part of cancer treatment plans. MTBs are widely considered the “gold standard” in cancer care delivery and are required for accreditation by the American College of Surgeons on Cancer Program. Preparing for MTBs is time-consuming and labor-intensive. We have previously published the largest real-world study of a digital solution (NAVIFY), showing significant decreases in the case preparation time compared to traditional methods.1 We now extend that study to evaluate the economic impact on costs of MTBs in an academic setting. Methods: The NAVIFY Tumor Board solution was introduced at the University of Missouri Health Care (MU) in 2018. Data was collected in three tumor boards (Breast, ENT, and GI) for pre- and post- NAVIFY implementation as previously published1 . For the current study, raw data was collected and preprocessed to obtain eight pertinent variables. A retrospective pre-post analysis was used to evaluate the economic effectiveness of NAVIFY. Using the salary data collected from publicly available sources, the average personnel cost/case (nurse navigator, radiology, pathology and genetic counseling) was analyzed for each tumor board for pre and post stable integration of NAVIFY. In addition, a system-wide cost projection study and payback analysis were also performed based on 12 tumor boards. Results: The average personnel cost/case after integration of NAVIFY showed a savings of 40% in breast MTB, 52% for ENT MTB, and 6% for GI MTB. Both Breast and ENT were considered to be the optimal use of the software after implementation. Using these two tumor boards, the average total personnel cost/case pre-NAVIFY was $93.20 and $49.55 post integration. Annual system-wide cost projections showed an annual savings of $299,614. Discounted payback period analysis showed a payback period of 0.17 years. Conclusions: Implementation of NAVIFY digital tumor board solution showed a significant impact on the total cost of tumor board preparation with overall a decrease in personnel cost/case of 53% with ideal implementation. The comparatively slight decrease in GI could be explained by an increase in cases reviewed from an average of 8 to 11 pre vs post NAVIFY requiring increased radiologist time, and poor user adoption by surgeons. In conclusion, implementation of a digital tumor board software provides significant savings in case preparation costs, second to decreased time costs of personnel. While not evaluated in this study, these cost savings do not take into account the increased potential clinical revenue that may also accompany the improved efficiency on provider time. References 1. Hammer RD, etal. Digital Tumor Board Solutions Have Significant Impact on Case Preparation. JCO Clin Cancer Inform. 2020 Aug;4:757-768.
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