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

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.

The cancer multidisciplinary team meeting: in need of change? History, challenges and future perspectives

“…Physicians appear to regard CDSSs favourably, with easy access to well-structured data, and reducing the time spent by clinicians on MDTM preparation and duration being desirable features [47]. However, concerns include incomplete or untrustworthy output generated by the system and insufficient adaptability of the system to local and contextual needs [47]. Going forward, CDSSs need further validation against improved clinical outcomes and demonstration of flexibility with application to local healthcare settings [47].…”

“…However, concerns include incomplete or untrustworthy output generated by the system and insufficient adaptability of the system to local and contextual needs [47]. Going forward, CDSSs need further validation against improved clinical outcomes and demonstration of flexibility with application to local healthcare settings [47]. CDSSs have huge potential to improve the consistency of MDT management recommendations and their convergence with guidelines by assisting with the collation of all relevant information for case discussion, highlighting the current evidence base, and providing data on previous management decisions for similar cases.…”

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“…In 2020, investigators in the Netherlands published semi-structured interviews to identify barriers and facilitators for implementing computerized clinical decision support systems (CCDSs) in managing LC cases among 26 various health care professionals involved in MTBs [33]. Easy access to well-structured patient data, reduction of time needed to prepare cases, and MTD duration were primary facilitators for the use of CCDSs.…”

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“…Capacity building [24,[29][30][31]44,46,49,[52][53][54][55] B28 Complexity of circularity in healthcare systems [22,47]…”