Australasian Radiology (2004) 48, 487–492 Radiation Oncology Diagnostic Radiology Comparison of face-to-face and videoconferenced multidisciplinary clinical meetings G Delaney, 1 S Jacob, 1 R Iedema, 2 M Winters 2 and M Barton 1 1 Collaboration for Cancer Outcomes Research and Evaluation (CCORE), South Western Sydney Area Health Service and 2 Centre for Clinical Governance Research, University of New South Wales, Sydney, New South Wales, Australia SUMMARY A trial of videoconferencing of multidisciplinary breast cancer clinical meetings between three public hospitals was conducted in an attempt to increase attendance by medical staff at the meetings, and thus facilitate multidisciplinary care for breast cancer patients. The videoconferences were compared with the previously existing face-to-face clinical meetings through questionnaires, attendance, number of cases discussed and anthropological analysis. Although more people attended the videoconferences than the face-to-face meetings, most of the participants in the trial preferred the face-to-face meetings to the videoconferences. The mean number of cases discussed at the videoconferences was significantly less than the mean number of cases presented at the face-to-face clinical meetings. The face-to-face meetings were informal, spontaneous and conducive to open discussion. In contrast, the video- conferences were formal and regimented. Multidisciplinary case discussion can be facilitated by videoconferencing. Some of the negative experiences we encountered could be overcome with changes in meeting format. Our experience may help others in setting up a successful multidisciplinary team via videoconference. Key words: breast cancer; multidisciplinary care; videoconferencing. INTRODUCTION The introduction of communications technology into medical practice can have an influence on the relationships between clinicians and possibly on medical practice itself. Digital tech- nology may affect several levels of communication between doctors and as a consequence may change how they perform their clinical work. This article describes the introduction of videoconferencing into multidisciplinary breast cancer clinical meetings and the resultant changes in the negotiation of diag- nostic and treatment decisions. Multidisciplinary care has been shown to have a positive effect on patient outcomes. Sainsbury et al. showed that surgeons managing 30 or more breast cancer patients per year recommended combined therapy (surgery with radiotherapy and chemotherapy or hormone therapy) to a higher percentage of their patients, than surgeons with a smaller caseload. 1 This difference translated into their patients having longer survival. Sainsbury noted that the improved outcomes for patients seen by specialist surgeons was not a simple function of surgical skill, but rather a function of multidisciplinary practice where interaction with oncology colleagues was seen as most important. Multidisciplinary care is usually standard practice in large hospitals but is more difficult to achieve in smaller hospitals as a result of the sporadic availability of specialist staff and a smaller patient load. Videoconferencing can potentially improve the access of both clinicians and patients at smaller hospitals to multidisciplinary clinics. South Western Sydney Area Health Service (SWSAHS) serves the health needs of a population of around 740 000 people spread over 6237 square kilometres. There are six public hospitals and several private hospitals in the area. The only multidisciplinary breast cancer clinical meetings within south-western Sydney were held weekly in the largest public G Delaney MB BS (Hons), MD, FRANZCR; S Jacob MB BS, MD; R Iedema PhD; M Winters BA (Hons); M Barton MB BS, FRANZCR. Correspondence: Associate Professor Geoff Delaney, Director of Radiation Oncology, Liverpool Health Service, Locked Bag 7103, Liverpool BC, NSW 1871, Australia. Email: Geoff.Delaney@swsahs.nsw.gov.au Submitted 25 July 2003; resubmitted 5 January 2004, 30 April 2004; accepted 14 July 2004.