ideasIdea
Credentialed diaspora oncologists staffing remote tumour boards for home-country hospitals
Thousands of oncologists trained in poorer countries now work abroad. A structured programme could let them join weekly video case conferences for hospitals back home, improving decisions at almost no cost.
Ad hoc tele-tumour boards between high-income and LMIC centres exist but are fragile and unmeasured. A formal programme would credential diaspora and partner specialists, schedule weekly boards by tumour type, use a standard case template, record recommendations, and audit whether they were implemented and whether outcomes changed. The cost is coordination, not salaries.
Hypothesis
Hospitals with a weekly structured remote tumour board will change management in at least 25% of presented cases and increase guideline-concordant treatment by at least 20 percentage points over one year.
Rationale
Multidisciplinary review changes management in a substantial minority of cases in every setting studied; the marginal value is highest where local specialist input is scarcest.
What would test it
Twelve hospitals, six with boards and six waitlisted, comparing concordance, time to treatment decision, and clinician-reported confidence.
Maturity
early clinical
Who has to act
clinic
Cost to try
Small (under $1M)
Years to first evidence
1
Bottlenecks it attacks
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
- Not enough oncologists, nurses, pathologists, physicists · The number of people with cancer is rising faster than the workforce trained to treat them.
- Knowledge reaches practice too slowly · Knowledge diffusion is slow: it takes years for a proven result to change what most patients receive, and no one can keep up with the literature.