Table II.

Coding of Interview Data

Code Name	Frequency of code in the interview data	Code Definition and Illustrative Quotation
Program goals	21	Refers to a physician’s ability to clearly state the goals and reasons for the VTB program. “One of [the goals] is to continue to foster collegiality between community hematologist oncologists and university people. Our hope is for cooperation and not competition, and I think this allows us to kind of get to know your faculty and they get to know ours. And from a professional development point of view, I think that is important.” –Community-based physician
Structure and process	102	Refers to the operational issues involved with preparing for and participating in the VTB. Frequent topics included tasks and time required to prepare for VTB presentations and the nature of discussion during the VTBs. “Every facility has their own speed to getting us the material. So, that sometimes takes a little time out of our -- it interferes with our workflow because we have to stop and get pieces to come through... So, we often will have to work up the tumors further to give the guys here, my clinicians, the information they need to treat the patient. So, our biggest challenge is the speed of getting the material and the, “Are we getting just the size, or are we getting some tissue we can work with?” – UNC physician “…if Mrs. Jones is going to be presented we have to have all the reports and probably multiple copies of CDs because I have to farm it out to different people. Then those different people have to get back to me or one of the other members of my breast imaging team to present it. There’s nothing worse than all of a sudden at conference I see some other stuff on the PET scan but I haven’t had anybody in the PET department review it.” –UNC Physician
Facilitators to participation	64	Refers to factors that enhance a physician’s desire to attend as a UNC physician or present a case at the VTB as a community-based physician, such as educational experience and reinforced confidence in the patient’s management plan. “It’s good for enrollment on studies because the outside docs don’t know what studies we have available so it’s a great way to publicize what we have, you know, they might not qualify for it now but if they relapse, then we have this available or we have this maintenance strategy available.” –UNC physician
Barriers to participation	108	Refers to factors that do not enhance a physician’s (UNC or community physician) desire to participate in the VTB program, such as operating model, technology issues, and time/budget constraints. “…our model is different from the patient-hospital model. We’re seeing patients pretty much all day. So unless I preventively block a slot, I’m usually not free at the times that you’re having tumor boards.” –Community-based physician “[T]here have been some really interesting, unique cases presented and I think sometimes people think that’s set the bar pretty high, and I think they’ll say to me I don’t have any interesting cases. It’s like it doesn’t have to be interesting necessarily – just something that could spark up a conversation and some discussion and that kind of thing. But so I think that’s why I think some people are just timid to go up there because they think their cases are not worth presenting.” – Community-based non-participant (staff member liaison to VTB program)
Treatment impact	22	Refers to when a physician speaks about the VTB program impact on their treatment decision. “Generally, we come out of that conference with a recommendation on whether to proceed with some treatment and the second thing is whether this is a patient who would be good to go to UNC to be formally seen by the multidisciplinary groups.” – Community-based physician
Benefits to physicians	16	Refers to when physicians mention the benefits of participating in the VTB program, either for themselves, their colleagues, or the institution as a whole. “The advantage of this approach [VTB] is that you get multiple specialists in at once… you have surgeons and medical oncologists and radiation oncologists [together]. You can hear different opinions and get a feel for what somebody might be missing or a different approach or a different thought.” –Community-based physician “Well, I mean, certainly, the more experience you get with these complicated cases, I mean, that’s always beneficial… any new case which presents its own unique set of twists and turns, and hearing what my colleagues have to say about it, and kind of where my stance is on it compared to what everyone else is thinking, I mean, that is valuable.”—UNC physician
Satisfaction	47	Refers to when a physician asserts excitement/no excitement for the program or mentions the perceived value/lack of value of the program or mentions the capability of the VTB program in a positive or negative way. “We have taken positive steps for patient care based on the recommendation in each case that we’ve presented. It was a very positive experience and something I definitely want to take advantage of again.” –Community-based physician
Program awareness	28	Refers to whether physicians mentioned knowing about the program or whether they had told colleagues about the program. “I think the people who have been using it have been groups that have had experience using it and they continue to use it over and over again, repeat users. I’ve not seen a lot of newer users recently.” –UNC physician
Recommendations	59	Refers to when a physician recommended or suggested ways to improve or enhance the VTB program. “Probably the number one [thing] is you need advocates. You need somebody at the site who really cares. And it’s not enough for them to say they care. They really have to care. You’ve got to have somebody here who cares. It’s probably got to be one of the [community-based] clinicians. I think that’s probably number one. Because if you don’t have that, it’s going to be hard to make it happen.” –Community-based physician “If there were some marketing that patients were aware that this was available I could see potentially that somebody might say, “Well, why don’t you present my case at their tumor board?” – Community-based, non-presenting physician