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Barriers and Facilitators for Implementation of a Computerized Clinical Decision Support System in Lung Cancer Multidisciplinary Team Meetings—A Qualitative Assessment

SIMPLE SUMMARY: Oncological computerized clinical decision support systems (CCDSSs) are currently being developed to facilitate workflows of multidisciplinary team meetings (MDTMs). To successfully implement these systems in MDTMs, the aim of this qualitative assessment was to identify barriers and...

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Detalles Bibliográficos
Autores principales: Klarenbeek, Sosse E., Schuurbiers-Siebers, Olga C. J., van den Heuvel, Michel M., Prokop, Mathias, Tummers, Marcia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830066/
https://www.ncbi.nlm.nih.gov/pubmed/33375573
http://dx.doi.org/10.3390/biology10010009
Descripción
Sumario:SIMPLE SUMMARY: Oncological computerized clinical decision support systems (CCDSSs) are currently being developed to facilitate workflows of multidisciplinary team meetings (MDTMs). To successfully implement these systems in MDTMs, the aim of this qualitative assessment was to identify barriers and facilitators for implementation and to provide actionable findings for an implementation strategy. The main facilitators for implementation of the CCDSS were considered to be easy access to well-structured data, and reducing time spent by clinicians on MDTM preparation and duration of the 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. Actionable findings for an implementation strategy were a usability test and validation study involving key users in the organization’s real-life setting. Given the growing interest in CCDSSs in oncology care, insight in barriers and facilitators for successful implementation seems highly relevant. ABSTRACT: Background: 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. Methods: 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. Results: 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. Conclusion: 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.