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

被引:6
作者
Kabukye, Johnblack K. [1 ,2 ,6 ]
Namugga, Jane [2 ,3 ]
Mpamani, Collins Jackson [2 ]
Katumba, Andrew [4 ]
Nakatumba-Nabende, Joyce [4 ]
Nabuuma, Hanifa [4 ]
Musoke, Stephen Senkomago [5 ]
Nankya, Esther [2 ]
Soomre, Edna [1 ]
Nakisige, Carolyn [2 ]
Orem, Jackson [2 ]
机构
[1] Stockholm Univ, Dept Comp & Syst Sci, Swedish Program ICT Developing Reg, SPIDER, Stockholm, Sweden
[2] Uganda Canc Inst, Kampala, Uganda
[3] Mulago Specialised Women & Neonatal Hosp, Kampala, Uganda
[4] Makerere Univ, Dept Elect Engn, Kampala, Uganda
[5] Univ Calif San Francisco, Global Programs Res & Training, Kampala, Uganda
[6] Stockholm Univ, Dept Comp & Syst Sci, SPIDER Swedish Program ICT Developing Reg, Borgarfjordsgatan 12,NOD Bldg,Campus Kista,POB 700, SE-16407 Stockholm, Sweden
关键词
telemedicine; cervical cancer; screening; visual inspection with acetic acid; cervicography; Uganda; digital health; LOW-INCOME; VISUAL INSPECTION; PROGRAMS; CHALLENGES; VACCINATION; PREVENTION; SYSTEM;
D O I
10.2196/45132
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
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.
引用
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页数:13
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