Digital health in oncology in Africa: A scoping review and cross-sectional survey

Kabukye, Johnblack K; Kakungulu, Edward; Keizer, Nicolette de; Cornet, Ronald

doi:10.1016/j.ijmedinf.2021.104659

Cited by 10 publications

(11 citation statements)

References 114 publications

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“…The use of telemedicine in the selected studies was synchronous (live exchange of patient information) as well as asynchronous (store and forward patient information). It should be noted that apart from videoconferencing there are several other components of digital health such as SMS and phone calls which could be used to book appointments, send reminders to patients, create awareness by posting content,and providing counselling and decision support for self-monitoring [ 19 , 29 ]. In addition, electronic health records are widely used to track the journey of cancer patients across facilities and to reduce the waiting time for diagnosis and treatment [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Morris et al [ 19 ] conducted a systematic review of the role of digital health in rural cancer care, but the scope was limited to application in rural areas. Kabukye et al [ 29 ] conducted a scoping review on the use of digital health in oncology in Africa and found that the long-term impact on cancer-related outcomes needs to be analysed rigorously.…”

Section: Introductionmentioning

confidence: 99%

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Role of digital health in coordinating patient care in a hub-and-spoke hierarchy of cancer care facilities: a scoping review

Venkataramanan,

Pradhan,

Kumar

et al. 2023

ecancer

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Background Coordinating cancer care is complicated due to the involvement of multiple service providers which often leads to fragmentation. The evolution of digital health has led to the development of technology-enabled models of healthcare delivery. This scoping review provides a comprehensive summary of the use of digital health in coordinating cancer care via hub-and-spoke models. Methods A scoping review of the literature was undertaken using the framework developed by Arksey and O’Malley. Research articles published between 2010 and 2022 were retrieved from four electronic databases (PubMed/MEDLINE, Web of Sciences, Cochrane Reviews and Global Health Library). The preferred reporting items for systematic reviews and meta-analyses extension for the scoping reviews (PRISMA-ScR) checklist were followed to present the findings. Result In total, 311 articles were found of which 7 studies that met the inclusion criteria were included. The use of videoconferencing was predominant across all the studies. The number of spokes varied across the studies ranging from 1 to 63. Three studies aimed to evaluate the impact on access to cancer care among patients, two studies were related to capacity building of the health care workers at the spoke sites, one study was based on a peer review of radiotherapy plans, and one study was related to risk assessment and patient navigation. The introduction of digital health led to reduced travel time and waiting period for patients, and standardisation of radiotherapy plans at spokes. Tele-mentoring intervention aimed at capacity-building resulted in higher confidence and increased knowledge among the spoke learners. Conclusion There is limited evidence for the role of digital health in the hub-and-spoke design. Although all the studies have highlighted the digital components being used to coordinate care, the bottlenecks, Which were overcome during the implementation of the interventions and the impact on cancer outcomes, need to be rigorously analysed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of digital health in coordinating patient care in a hub-and-spoke hierarchy of cancer care facilities: a scoping review

Venkataramanan,

Pradhan,

Kumar

et al. 2023

ecancer

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“…Mobile health applications can empower patients and caregivers by providing educational resources, symptom monitoring tools, and medication reminders. These technologies can improve patient outcomes, enhance efficiency, and reduce healthcare costs in resource-constrained settings [ 15 ].…”

Section: Potential Solutionsmentioning

confidence: 99%

Addressing cancer care in low- to middle-income countries: a call for sustainable innovations and impactful research

Stefan,

Tang

2023

BMC Cancer

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“…Other studies have used cervical images to train artificial intelligence (AI) models, which could potentially substitute the expert when one is unavailable for a second opinion or supplement them [ 38 , 41 , 46 ]. In addition, similar telemedicine solutions have been used to improve pathology services , which is another major challenge not only for CaCx but also for cancer control in general [ 22 , 47 , 48 ]. Similar to cervicography, in telepathology, Pap smears or microscopy slides are scanned and shared with an expert for a second opinion or AI algorithms are used to assess the scanned slides to detect abnormalities.…”

Section: Introductionmentioning

confidence: 99%

“…Most evaluations have focused on feasibility, usability, and acceptability, with limited focus and evidence on clinical outcomes. Moreover, despite several studies from other African countries [34][35][36]39,40,[42][43][44][45]49,54,55], implementations of digital health in CaCx screening and diagnosis in Uganda are limited [48].…”

Section: Introductionmentioning

confidence: 99%

Implementing Smartphone-Based Telemedicine for Cervical Cancer Screening in Uganda: Qualitative Study of Stakeholders’ Perceptions

Kabukye¹,

Namugga²,

Mpamani³

et al. 2023

J Med Internet Res

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Background In Uganda, cervical cancer (CaCx) is the commonest cancer, accounting for 35.7% of all cancer cases in women. The rates of human papillomavirus vaccination and CaCx screening remain low. Digital health tools and interventions have the potential to improve different aspects of CaCx screening and control in Uganda. Objective This study aimed to describe stakeholders’ perceptions of the telemedicine system we developed to improve CaCx screening in Uganda. Methods We developed and implemented a smartphone-based telemedicine system for capturing and sharing cervical images and other clinical data, as well as an artificial intelligence model for automatic analysis of images. We conducted focus group discussions with health workers at the screening clinics (n=27) and women undergoing screening (n=15) to explore their perceptions of the system. The focus group discussions were supplemented with field observations and an evaluation survey of the health workers on system usability and the overall project. Results In general, both patients and health workers had positive opinions about the system. Highlighted benefits included better cervical visualization, the ability to obtain a second opinion, improved communication between nurses and patients (to explain screening findings), improved clinical data management, performance monitoring and feedback, and modernization of screening service. However, there were also some negative perceptions. For example, some health workers felt the system is time-consuming, especially when it had just been introduced, while some patients were apprehensive about cervical image capture and sharing. Finally, commonplace challenges in digital health (eg, lack of interoperability and problems with sustainability) and challenges in cancer screening in general (eg, arduous referrals, inadequate monitoring and quality control) also resurfaced. Conclusions This study demonstrates the feasibility and value of digital health tools in CaCx screening in Uganda, particularly with regard to improving patient experience and the quality of screening services. It also provides examples of potential limitations that must be addressed for successful implementation.

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Digital health in oncology in Africa: A scoping review and cross-sectional survey

Cited by 10 publications

References 114 publications

Role of digital health in coordinating patient care in a hub-and-spoke hierarchy of cancer care facilities: a scoping review

Role of digital health in coordinating patient care in a hub-and-spoke hierarchy of cancer care facilities: a scoping review

Addressing cancer care in low- to middle-income countries: a call for sustainable innovations and impactful research

Implementing Smartphone-Based Telemedicine for Cervical Cancer Screening in Uganda: Qualitative Study of Stakeholders’ Perceptions

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