Klarenbeek Sosse E, Schuurbiers-Siebers Olga C J, van den Heuvel Michel M, Prokop Mathias, Tummers Marcia
Department of Medical Imaging, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Department of Pulmonary Diseases, Radboud Institute for Molecular Life Sciences, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
Biology (Basel). 2020 Dec 25;10(1):9. doi: 10.3390/biology10010009.
Oncological computerized clinical decision support systems (CCDSSs) to facilitate workflows of multidisciplinary team meetings (MDTMs) are currently being developed. To successfully implement these CCDSSs in MDTMs, this study aims to: (a) identify barriers and facilitators for implementation for the use case of lung cancer; and (b) provide actionable findings for an implementation strategy.
The Consolidated Framework for Implementation Science was used to create an interview protocol and to analyze the results. Semi-structured interviews were conducted among various health care professionals involved in MDTMs. The transcripts were analyzed using a thematic analysis following a deductive approach.
Twenty-six professionals participated in the interviews. The main facilitators for implementation of the CCDSS were considered to be easy access to well-structured patient data, and the resulting reduction of MDTM preparation time and of duration of MDTMs. Main barriers for adoption were seen in incomplete or non-trustworthy output generated by the system and insufficient adaptability of the system to local and contextual needs.
Using a CCDSS in lung cancer MDTMs was expected to increase efficiency of workflows. Successful implementation was seen as dependent on the reliability and adaptability of the CCDSS and involvement of key users in the implementation process.
目前正在开发肿瘤学计算机化临床决策支持系统(CCDSS),以促进多学科团队会议(MDTM)的工作流程。为了在MDTM中成功实施这些CCDSS,本研究旨在:(a)确定肺癌用例实施的障碍和促进因素;(b)为实施策略提供可操作的结果。
使用实施科学综合框架创建访谈协议并分析结果。对参与MDTM的各类医疗保健专业人员进行了半结构化访谈。采用演绎法,通过主题分析对访谈记录进行分析。
26名专业人员参与了访谈。实施CCDSS的主要促进因素被认为是能够轻松获取结构良好的患者数据,以及由此减少MDTM的准备时间和会议时长。采用该系统的主要障碍在于系统生成的输出不完整或不可信,以及系统对当地和实际需求的适应性不足。
在肺癌MDTM中使用CCDSS有望提高工作流程的效率。成功实施被视为取决于CCDSS的可靠性和适应性,以及关键用户在实施过程中的参与度。