September 7, 2021
Gynecologic cancer contributes significantly to the number of cancer cases each year in Zambia, but weaknesses in referral, communication and coordination systems present challenges to care. A recent article in the Journal of Cancer Policy describes an intervention to establish a low-cost digital system to manage information related to cancer care, showing the feasibility of implementing these systems in low-resource settings.
A gynecologic oncology tumor board at the country’s lone cancer center integrates representatives of different fields involved in cancer care in a multidisciplinary team (MDT). The new system deploys a color-coded dashboard that allows the tumor team to easily track patients’ progress through the care continuum and respond to delays.
The article’s lead author, Katerina Pattee, MPH, is among the first graduates in a new global health concentration at the UNC Gillings School of Global Public Health. She received a Master of Public Health degree in 2021 and participated in the Gillings School’s Zambia Hub, which was established to enhance global learning and increase the School’s impact in Zambia.
“The UNC Zambia Hub fostered this collaboration which allowed me to become part of the MDT and publish this research,” said Pattee. “Even with COVID-19 and travel restrictions that prohibited me from moving to Zambia, my Gillings mentors and advisors helped me complete this practicum and encouraged me to publish my findings. I have found nothing but encouragement from my professors and peers at Gillings, and this gave me the confidence and knowledge to publish this manuscript.”
The intervention and article advance the field of oncology by outlining the steps to integrate similar technology in a LMIC (low- to middle-income country) setting and exposing the inherent difficulties of doing so. The growth of digital health shows great potential to improve efficiency, communication between providers, and the quality and continuity of care within oncology and other fields.
“Clinical providers, public health professionals and technological innovators could all benefit from this research because these innovations can be the reason why patients receive timely, high-quality and continual care in the future,” said Pattee. “Digital health is changing the medical and public health fields, and projects like this are integral to making sure that these innovations extend to low-resource health systems.”
Pattee notes that few previous studies were conducted in sub-Saharan Africa, and that this study is unique in its partnership with an established MDT and incorporation of a user-friendly data management system. However, the study team found that digital systems can form “silos” when not tied to a national network or standard. Lack of confidence in the system among care providers, lack of technological knowledge or effort among users, and the need for dedicated upkeep of the system were barriers to implementation.
“This research is integral to the field of digital health in addition to the rapidly globalizing medical field that extends far beyond Zambia,” said Pattee. “This type of project could allow a more efficient treatment system and plan, better communication between providers leading to a higher quality of care, and a better tracking system of patients to decrease the number of patients lost to follow-up. All three of those results would be a great improvement not only to the gynecologic oncology system of care, but to the health system as a whole, in Zambia and similar contexts.”
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