BACKGROUND
Digital medicine shows high potential to improve patient care management around the world. Even though a digital solution is technologically well implemented, its sustained use can be hindered by numerous factors. Consequently, the technology may fail to progress beyond the pilot stage and may never reach end-users nor patients. In the field of cervical cancer, many computer-aided diagnosis (CAD) algorithms have been developed for the assessment of cervical lesions but require further investigation in terms of feasibility and effectiveness in real clinical conditions.
OBJECTIVE
The current study focuses on challenges perceived by healthcare providers (HCPs) for the sustained use of a cervical cancer CAD tool for visual inspection with acetic acid (VIA) in West Cameroon. It aims to identify common barriers and facilitators to ensure a smooth adoption of the technology, in that specific context of use, but also in wider settings.
METHODS
A qualitative methodology was used to identify the main barriers to adoption of the technology and potential solutions to those challenges. Participants of this study include 8 HCPs (6 midwives and 2 gynaecologists), all working in the district of Dschang in Cameroon. While focus groups were conducted to discuss with the midwives, individual interviews explored the perspectives of the medical doctors. All interviews were audio-recorded, transcribed and then coded independently by two researchers using the ATLAS.ti software. The Technology Acceptance Lifecycle was used as a framework to analyse the results.
RESULTS
The identified key elements influencing a sustained use of CAD tools for VIA by HCPs were perceived as part of a pre-adoption phase. Barriers include ease-of-use of the system, confidentiality concerns, limited infrastructure and resources as well as change in the workflow. Facilitators mainly encompass validation of the technology in terms of performance, usability and integration in the patient care, and provision of services complementary to the technology such as tailored training of the HCPs. This approach would enhance the HCPs trust in the technology, without which, a sustained use cannot be achieved. Most importantly, the users need to be involved early and regularly provide feedback about the ease-of-use, usefulness and efficiency of the system.
CONCLUSIONS
Focusing on the HCPs perspectives in West Cameroon, the current study provides practical insights regarding the use of CADs for VIA in clinical settings. In addition to the technology readiness and ease of use, numerous elements should be considered at an early stage of the development of the solution to ensure a proper adoption and to reach the end-users. Those elements include a deep understanding of the context of use, of its end user, training, assistance for proper use and maintenance as well as robust clinical evidence.