Please cite this article in press as: B. Kane, S. Luz, “Do no harm”: Fortifying MDT collaboration in changing technological times, Int. J. Med. Inform. (2013), http://dx.doi.org/10.1016/j.ijmedinf.2013.03.003 ARTICLE IN PRESS IJB-2976; No. of Pages 13 i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s x x x ( 2 0 1 3 ) xxx–xxx j ourna l h omepage: www.ijmijournal.com “Do no harm”: Fortifying MDT collaboration in changing technological times Bridget Kane a,b,*,1 , Saturnino Luz b a St. James’s Hospital, Trinity College Dublin, Ireland b School of Computer Science and Statistics, Trinity College Dublin, Ireland a r t i c l e i n f o Article history: Received 4 May 2012 Received in revised form 18 March 2013 Accepted 20 March 2013 Keywords: Collaborative work Teamwork Medical decision-making a b s t r a c t Purpose: To examine the changes in multidisciplinary medical team activity and practices, with respect to the amount of patient cases, the information needs and technology used, with up to 10 multidisciplinary teams (MDTs) in a large teaching hospital over a 10-year period. Methods: An investigation of MDT meeting activity was undertaken in November 2005 and repeated in November 2012 for the MDTs at a large university teaching hospital. Analysis of data from 8 MDTs was informed through long-term ethnographical study, and supple- mented with 38 semi-structured interviews and a survey from 182 staff members of MDTs. Results: Work rhythms change over time as a function of the volume of work and technology changes, such as the use of a picture archive and communication system (PACS), videocon- ferencing and an electronic patient record (EPR). Maintaining cohesive teamwork, system dependability, and patient safety in the context of rapid change is challenging. Conclusions: Benefits of MDT work are in evidence, but the causes are not fully understood. Instead of asking ‘how can technology support more MDT activity?’, we ask ‘how can we preserve the benefits of human–human interaction in an increasingly technological envi- ronment?’ and ‘how can we ensure that we do no harm?’ when introducing technology to support an increasingly demanding collaborative work setting. Introducing technology to streamline work might instead threaten the experienced improvement in patient services. © 2013 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Multidisciplinary medical team meetings (MDTMs) are an example of synchronous collaboration, with asynchronous components, among medical specialties for a specific purpose. MDTMs were introduced over 25 years ago as a mechanism of collaborative diagnosis and patient management. Intuitively they are good practice because all of the professional groups are involved in the clinical decisions affecting individual ∗ Corresponding author. Tel.: +353 18962381; fax: +353 16772204. E-mail address: kaneb@tcd.ie (B. Kane). 1 B. Kane is a Marie Curie (ERCIM) Fellow and was an IRCSET Fellow under the Enterprise Partnership Scheme with St. James’s Hospital Board at the time of this study. patients [1,2]. However, the system is increasingly under pres- sure from technological developments, legislative require- ments and economic challenges. Over the past 10 years in particular, in Ireland and in the UK, we have witnessed a dramatic increase in the develop- ment of multidisciplinary team (MDT) work in healthcare. St. James’s Hospital in Dublin experienced an uptake from 20% of patients being managed by an MDT in the mid-1990s com- pared with over 80% in 2004, and a 50% increase in the number of MDTMs between 2003 and 2005 [3], for example. A number of 1386-5056/$ – see front matter © 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijmedinf.2013.03.003