Technology
imaging is unavailable, or the patient’s work-up is incomplete, the meeting cannot make a treatment decision. The case is deferred. The time invested by radiologists, pathologists, specialist nurses and coordinators in preparation is wasted and the patient’s treatment is delayed. Research into MDT workflows has consistently identified data gaps as a primary source of wasted meeting time. A 2025 MSD-commissioned white paper, drawing on qualitative research with UK oncology clinicians, found that practitioners regularly described moving between multiple screens and dashboards during meetings, due to fragmented information systems, and cited examples of cases discussed at length only to discover that a critical result was still outstanding, forcing deferral to a later meeting.7
In a context
where cancer waiting time targets are already under acute pressure, such deferral represents a real clinical risk. The problem is compounded by the way MDT
lists are currently constructed and managed. Most teams continue to operate from a flat list that categorises patients broadly (pre- operative, post-operative, new referral) without differentiating by case complexity. Research has shown that clinical teams frequently use MDT meeting time to input data live, transforming what should be a decision-making session into a collective form-filling exercise.8 This consistent misuse of expert clinical time
is precisely what the Frontiers in Health Services review of NHS England’s streamlining framework sought to address: by prioritising complex cases for full discussion, while routing straightforward cases through agreed standards of care, meetings can be refocused on the patients who would benefit most from multidisciplinary scrutiny.9
The EPR red herring The instinctive response to a data fragmentation problem is to pursue full data integration by attempting to connect the MDT to the Electronic Patient Record (EPR) system and allow clinical information to flow automatically into meeting
preparation. In practice, this is a solution that most NHS Trusts are unable to achieve. NHS England currently operates with a
patchwork of EPR systems. Regional and national MDTs may span providers using entirely different platforms, none of which can readily communicate with one another. Even where integration is technically feasible, the costs, implementation timelines and resource demands of an ERP overhaul are staggering, and the benefits are dubious at best. There is also a quality problem with EPR-
sourced data that is frequently overlooked. Hospital EPR systems are poorly suited to capturing a full clinical picture. Past medical history and current medications are more reliably documented in primary care records, which remain siloed from secondary care systems. Standard EPR interfaces typically restrict data import to PDFs, creating a rigid, format- dependent workflow that fails to accommodate the variety of information such as blood test images, radiology reports pasted from external portals, video clips of clinical assessments, or consultant letters from community teams. What is required is a flexible data layer that sits above existing systems and allows any clinician from any care setting to contribute the information relevant to their patient, in any format.
What clinically native digital tools can achieve A cloud-based asynchronous MDT platform for digestive tract cancer demonstrated measurable improvements in both MDT coverage rates and guideline compliance, including for patients with stage III rectal
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cancer, by enabling clinicians unable to attend asynchronously to contribute their assessments in advance.10
Often the specialist clinician who
cannot attend the meeting in person may provide a critical voice that can materially change the treatment decision made for their patient, enabling them to participate in the discussion can change patient outcomes. Digital tools that enable asynchronous
participation address this directly. They allow the respiratory physiotherapist, the community mental health nurse, or the palliative care consultant to record a structured opinion before the meeting, available to the room even when they are not. They also create a natural audit trail, satisfying clinical governance requirements and contributing to building a significant body of research.
Automation where the gains are greatest The most impactful digital improvements to MDT working are not necessarily the most sophisticated. Replacing the cycle of Word document submission, manual email, and spreadsheet entry with automated referral processing, for example, removes a low-value administrative task that currently consumes coordinator time and introduces transcription error. Automated population of standardised fields, flagging of incomplete test results before the meeting date, and pre-generated case summaries that draw from multiple source documents are also targeted interventions that free clinical time without requiring a tech overhaul. Automatic triaging can help sort a case list by
Andrey Popov -
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Oostendorp/
peopleimages.com -
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