{"entity":{"id":"idea-acc-universal-asynchronous-second-opinion","kind":"idea","name":"An asynchronous expert second opinion for every new advanced-cancer diagnosis","aka":[],"tldr":"Every patient newly diagnosed with advanced cancer would have their records reviewed by an expert centre within a week, without travelling. The review often changes the plan.","summary":"Second-opinion studies consistently show that expert review changes diagnosis or management in a substantial minority of cases, especially in pathology and molecular interpretation. Providing an asynchronous, record-based expert review for all new stage IV diagnoses, funded by payers and delivered by accredited centres, would spread expertise without moving patients. AI could pre-structure the record to reduce reviewer time.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Fragmented care and guideline gaps): Hanna et al., Mortality due to cancer treatment delay: systematic review and meta-analysis (BMJ 2020)","url":"https://doi.org/10.1136/bmj.m4087"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-care-fragmentation","b-knowledge-diffusion","b-trial-enrolment"],"keyPapers":["paper-hanna-bmj"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Universal second opinion will change management in at least 15% of advanced cancer cases and increase enrolment in appropriate trials and use of targeted therapy in eligible patients.","rationale":"The value of second opinion is established; the gap is access, which is inequitably distributed toward well-informed patients near academic centres.","test":"A payer pilot in one region offering review to all new stage IV patients, measuring change in management, trial enrolment, and patient satisfaction.","maturity":"speculative","actor":"payer","cost":"medium","horizonYears":3},"route":"/ideas/idea-acc-universal-asynchronous-second-opinion/","neighbours":{"bottleneck":[{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"},{"id":"b-knowledge-diffusion","kind":"bottleneck","name":"Knowledge reaches practice too slowly","route":"/bottlenecks/b-knowledge-diffusion/"},{"id":"b-trial-enrolment","kind":"bottleneck","name":"Trials enrol too few, too slowly","route":"/bottlenecks/b-trial-enrolment/"}],"paper":[{"id":"paper-hanna-bmj","kind":"paper","name":"Mortality due to cancer treatment delay: systematic review and meta-analysis","route":"/key-papers/paper-hanna-bmj/"}]}}