Informing the future of multidisciplinary oncology clinics: System-wide insights from an academic-community health system.

61 Background: High quality cancer care often relies on a collaborative, prospective, and synchronous multidisciplinary approach. However, the structure and execution of multidisciplinary clinics (MDCs) and tumor boards (TBs) can vary widely, even within a single health system. To guide the development of an integrated Multidisciplinary Care Model across our health system, we surveyed oncology clinics to characterize the current state of multidisciplinary oncology care (MDOC). Here we present the findings and implications for MDCs; TB-related results will be presented separately. Methods: A cross-sectional survey was distributed to clinical and administrative leaders at 10 oncology sites within a multiregional academic-community health system, including 2 academic medical centers (AMCs) and 8 community sites. The survey assessed MDC structure, care coordination (CC) processes (e.g., nurse navigation, referral workflows), and barriers to collaboration. Responses were analyzed using descriptive statistics and thematic analysis of open-ended responses. Results were shared with Cancer Service Line leadership, including representatives from Surgical Oncology and Informatics. Results: Survey completion was 100%. A total of 22 synchronous MDCs were identified, involving coordinated care by two or more specialists across disease sites including Brain (1), Breast (5), Cutaneous (2), Genitourinary (4), Head and Neck (2), Hepatobiliary (1), Pancreas (1), Gastrointestinal/Rectal (2), Splanchnic Thrombosis (1), and Thoracic (3), each aligned with a TB. Twelve asynchronous, but formally organized, MDCs were reported for Breast (3), Cutaneous (1), Gynecology (2), Head and Neck (1), Musculoskeletal (2), Sarcoma (1), and Thoracic (2). The two AMCs provided 14 synchronous and 6 asynchronous MDCs, while community sites offered 8 synchronous and 6 asynchronous MDCs. Most MDCs at the AMCs occur weekly; whereas MDCs in the community are often biweekly. Breast oncology was the most common MDC in the community (6). CC was supported by an array of advanced practice providers (APPs), nurse navigators (RNNs), and/or administrative assistants (AAs), with primary coordination via email and EMR referrals. Commonly cited needs for optimizing collaboration include more APPs, RNNs, AAs, clinic space, presence of expert subspecialists, research opportunities, documentation tools, and marketing support. Conclusions: This survey highlights substantial heterogeneity in MDOC models across the health system. Key opportunities include standardizing CC, expanding access to expert providers, improving infrastructure, and enhancing clinical research capacity at community sites. These findings will guide the development of scalable, system-wide interventions to improve multidisciplinary cancer care.