# A digital second-opinion network answering community oncologists within 72 hours

Source: https://onco.cc/ideas/idea-data-72-hour-second-opinion-network/  
OnCo record `idea-data-72-hour-second-opinion-network` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Any oncologist could send a difficult case, with the records, to a specialist centre and get a written expert opinion back within three days, free to the patient.

## Summary

Expertise is concentrated in a few centres; most patients are treated elsewhere. Asynchronous e-consultation (as in Project ECHO and tele-tumour boards) works but is patchy. The proposal is a funded national network with a standard case bundle (patient-held record or mCODE export), triage to the right subspecialist, a 72-hour written opinion, structured recording of the recommendation, and outcome follow-up to measure impact.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Rapid second opinions will change management in a substantial minority of referred cases and will be associated with higher guideline concordance and trial referral.
- Rationale: Second-opinion studies in pathology and oncology find management changes in a significant share of cases; speed and structured data are what make the model scalable.
- Proposed test: Run the network for one year in one region; report turnaround, proportion of opinions changing management, and trial referrals; compare guideline concordance with non-referred matched cases.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Bottleneck evidence (Knowledge reaches practice too slowly): Morris, Wooding & Grant, The answer is 17 years, what is the question (JRSM 2011): https://doi.org/10.1258/jrsm.2011.110180

## Connected records

- ideas: [A patient-held cancer record that travels across providers and borders](https://onco.cc/ideas/idea-data-patient-held-cancer-record/)
- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/)
- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Knowledge reaches practice too slowly](https://onco.cc/bottlenecks/b-knowledge-diffusion/), [Rare and paediatric cancers without markets](https://onco.cc/bottlenecks/b-rare-cancers/)
- key papers: [The answer is 17 years, what is the question: understanding time lags in translational research](https://onco.cc/key-papers/paper-morris-j-r-soc-med/)

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