A Shanghai hospital recently carried out the city's first online, transnational, multidisciplinary team consultations for four patients overseas who were unable to return for follow-up treatment due to COVID-19 pandemic restrictions.

All four cases were patients of the oral and maxillofacial department at Shanghai Ninth People's Hospital, which is affiliated with Shanghai Jiao Tong University's School of Medicine. Most had their first consultation in Shanghai last year, underwent surgery, and had booked follow-up treatment around Christmas but were unable to return.

The hospital organized the online multidisciplinary team consultations at noon on Dec 31 after considering time differences. The four patients were in Australia, the United Kingdom and the United States.

The consultations were chaired by the department's head and deputy head and attended by the cases' attending doctors and doctors from related departments.

The attending doctors and the patients first introduced the backgrounds of their cases as well as a range of image measurement data. Doctors in front of the screen raised questions to understand each case's current situation and problems, and surgeons and experts in periodontics then provided follow-up treatment solutions after discussions.

During one consultation, the doctors learned that the patient had just tested positive for the novel coronavirus and was undergoing self-isolation at home. Experts said internet medical services are playing a vital role during the pandemic.

The doctor in charge of that patient's case, department deputy head Zhu Min, said that the patient previously had facial plastic surgery in the US but had turned to the Shanghai hospital due to an unsatisfactory result and postoperative complications. She and Wang Xudong, vice-president of the hospital and director of the department, designed a sequence of treatment plans for the patient.

The young male patient said he and his family had been pleased to learn he could continue medical diagnosis and treatment via the internet. His mother also joined the online consultation.

"The hospital's online MDT consultation was first put into use in June for several patients in difficult and complicated situations who were in different parts of the country," Wang said. "The system allows one patient, four relatives and nine doctors to be online for video consultation simultaneously."

The hospital said two factors had made it possible for the department to conduct the first online, transnational, multidisciplinary team consultations: further diagnosis and treatment plans were not dependent on medical examinations, such as MRI scans and blood tests; and patients trusted that the hospital represents the best international standard in the discipline.

Wang said the department initiated such consultations in the 1990s. It receives around 160,000 patients a year and many rely on joint diagnosis and treatment in multiple disciplines.