[Necessary prerequisites for the function of an oncological competence center. Information technology, documentation of findings and telecommunication].
BACKGROUND
The organisation of an interdisciplinary cancer center, especially the establishment of a daily tumorboard requires adequate hardware and intelligent software, which is not available in most hospitals and described here with concepts, realisation and first clinical results.


METHODS
Based on a TCP/IP network and several inhomogeneous department subsystems we developed an intranet-based oncological documentation- and conference software (oncofile), which can be easily operated and administered in a web browser. Common digital media can be imported and the concept allows for paperless organisation of the daily tumor board. The expert decisions are documented online during tumor board runtime together with selected clinical images and the consensus of the decisionmakers. Local therapeutic guidelines as well as trial information can be accessed over the intranet, and interfaces for internet- and telecommunication are used for second opinion and integration of external expertise.


RESULTS
Between 10/99 and 2/2002 3298 presentations of 2438 cases were made in the daily tumor board. 74% of the patients had a curative oncological treatment concept, and 24% of the patients received neoadjuvant treatment. 49% of the patients were scheduled for primary resection. Six patients can be effectively handled in a 30 minute tumorboard.


CONCLUSIONS
The establishment of a daily tumorboard is possible by help of intranet-technology, a central database with web clients and moderate hardware investments. The composition of the patient cohort as well as all decisions ever made to a particular patient are transparent at all times. Prospective quality control studies are under way.
Bumm
R
R
Chirurgische Klinik und Poliklinik Munchen. bumm@nt1.chir.med.tu-muenchen.de
Siess
M
M
Lange
M
M
Siewert
J R
JR
D002173:Cancer Care Facilities / Q000458:organization & administration*; D003131:Combined Modality Therapy; D003199:Computer Systems; D003628:Database Management Systems / Q000458:organization & administration; D004282:Documentation / Q000379:methods*; D005858:Germany; D006751:Hospital Information Systems / Q000458:organization & administration*; D006801:Humans; D020407:Internet; D016347:Medical Records Systems, Computerized / Q000458:organization & administration; D009369:Neoplasms / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration*; D011873:Radiology Information Systems / Q000458:organization & administration; D013685:Telecommunications / Q000458:organization & administration*; D014584:User-Computer Interface