On the morning of November 15, 2018, the Second Affiliated Hospital of Zhejiang University and the Affiliated Hospital of Harvard University Medical School in the United States conducted the first joint Sino-US MDT based on the Medebound HEALTH telehealth platform. The aim of this multiple disciplinary team (MDT) was to create the best treatment strategy for a very complicated 76-year-old male colon cancer patient in China.
After more than one hour of in-depth discussion, experts from both sides had a better understanding of the difficult problems of the patient’s diagnosis and treatment. Chinese and American experts jointly formulated the subsequent treatment plan for the patient.
That same day, intestinal oncologists from the Second Affiliated Hospital of Zhejiang University (Second Hospital of Zhejiang Medical) and the Beth Israel Deaconess Medical Center (BIDMC) of the Affiliated Hospital of Harvard Medical School in the United States joined forces for the first time on the Medebound HEALTH platform.
This cross-border “tumor board” was carried out supporting patients with difficult conditions consulting both physicians in their home country and consulting US-based physicians to seek further insights on treatment strategies. It allows access to top cancer and rate disease specialists in the US.
MDT consultation site facilitated by Medebound HEALTH
The multiple disciplinary team (MDT) model originated in the 1990s and was first proposed by a medical expert group in the United States. A multidisciplinary team is a group of health care workers who are members of different disciplines, each providing specific services to the patient.
In this model, experts from the departments of surgery, internal medicine, radiotherapy, imaging, pathology, and other departments form a multiple disciplinary team. They propose the best treatment plan suitable for the patient’s current condition, and then strictly implement the treatment plan, and at the same time regularly evaluate and optimize the quality of the feedback on the patient’s treatment, and continuously modify the existing diagnosis and treatment model.
This type of MDT diagnosis and treatment model is not new in many tertiary hospitals in China. In the “Internet +” era, some hospitals have more in-depth requirements for MDT and have a longer-term perspective. However, cross-border MDT is not usually practiced due to several logistics limitations. By using Medebound HEALTH telehealth solutions and its network of US-based medical experts, hosting an international MDT like this becomes feasible to ask a US oncologist online.
US participating experts
Raul S. Gonzalez, MD, Associate Professor of Pathology, Harvard Medical School
Koenraad J. Mortele, MD, Associate Professor of Imaging, Harvard Medical School
Harvard University School of Medicine, Surgery, Associate Professor Vitaliy Y. Poylin, MD
Harvard Medical School Department of Medical Oncology Doctor Benjamin L. Schlechter, MD
U.S. participating experts from Harvard Affiliated Hospital
Chinese participating experts
Professor Zhang Suzhan, Director of the Institute of Cancer Research, Zhejiang University /Doctoral Supervisor
Second Hospital of Zhejiang Medical vice president / doctoral tutor Professor Ding Kefeng
Professor Yuan Ying, Deputy Director/Doctoral Supervisor, Department of Oncology, Zhejiang Medical Second Hospital
Professor Li Jun, Chief Physician of Oncology Surgery, Zhejiang Medical Second Hospital, Doctor of Medicine
Nine doctors, including Wang Liuhong, Deputy Chief Physician of Zhejiang University Imaging Medicine
Chinese participating experts
With the assistance of the staff of Medebound HEALTH, the two sides conducted real-time communication through the online platform and discussed in-depth the best treatment plan. At the same time, thousands of physicians also watched this MDT simultaneously in real-time to learn from this unique cross-hemisphere experience.
Summary of the consultation
A 76-year-old male patient with moderately differentiated adenocarcinoma of the colon with liver metastases. After comprehensive treatments such as surgery, chemotherapy, cetuximab, and radiofrequency ablation, his condition is stable; some liver metastases have shrunk, and most liver metastases have disappeared. The patient’s maintenance treatment and follow-up treatment plan were discussed.
Based on the patient’s current condition, American experts believed that maintenance treatment could be considered for patients who do not consider surgical options or refuse surgery with liver metastases. Although maintenance treatment can delay the disease process, it will not change the overall survival time of the patient.
US doctors recommended close observation and waiting without any chemotherapy. US doctors believed that the administration of cetuximab is not unreasonable, but maintenance therapy is not recommended for patients whose condition improves because maintenance therapy does not change the overall survival time of patients. Finally, American doctors suggested that patients should be closely observed and radiofrequency ablation therapy should be considered, and chemotherapy can be followed up when the lesion progresses.
After more than an hour of in-depth discussion, the two parties reached an agreement on the patient’s follow-up treatment strategy. In addition, the two groups of physicians also had a lively discussion on topics such as tumor pathology and surgical treatment of liver metastases.
After the meeting, American experts and Chinese experts have a positive impression of this MDT discussion and communication.
Experts believe that the cross-border MDT is of great benefit to improving local medical capabilities, cultivating young doctors, and assisting with the diagnosis and treatment of difficult patients who long for the best US-based doctors for consultations without travelling abroad.
By using the cross-border MDT, Medebound HEALTH hopes to bring US doctor resources to Asia through the internet and technology, bringing substantial help to local doctors and patients alike. Patients can enjoy world-class, high-quality medical services at their own doorsteps.