Deployment and integration of a cognitive technology in China: Experiences and lessons learned.

Abstract

6538 Background: Cognitive technologies are rapidly being introduced in oncology for decision-support, prescribing therapy, predicting risk, reducing medical errors and for care management. Few studies have reported on successful approaches for clinical adoption. We report the early adopter experience of BahealIntelligenceTechnologyCo., Ltd. (Baheal), across China within a 2-year period (April 2017-January 2019). We also describe lessons and experiences of oncology users. Methods: Baheal developed collaborative agreements for use of IBM Watson for Oncology (WFO) in 96 hospitals across 8 provinces. Key opinion leaders who saw the potential for AI were recruited as champion advocates. A 29-item survey conducted included usability and integration within clinical workflow. 85 questionnaires were distributed to oncologists who were major WfO users; 51 were completed. All questionnaires were completed anonymously and de-identified prior to analysis. Results: As of January 31, 2019, 866 physicians have entered a total of 52,537 cancer cases into WfO. Most users approved of both the quality (44/51, 86.3%) and comprehensibility (45/51, 88.2%) of treatment options, rationales, and literature references. WfO was most frequently applied in the context of inpatient cases reviewed by a multidisciplinary tumor board (MDT) (44/51, 86.3%). A lack of locally available treatments in WfO was cited as an area for improvement by two-thirds of users (34/51, 66.7%). CDS was rated from 0 (lowest) to 10 (highest) for each of the following uses: EBM medical education (8.1); assistance with literature (7.7); medical care quality control (7.3); second opinion consultations (7.0); case review with tumor board (6.9); and decision support (6.4). Overall, users were willing to recommend CDS to patients and other clinicians (7.3). Conclusions: WfO CDS, employed in a variety of settings, was viewed positively by more than 86% of users, with perceived benefits differing by context. Future incorporation of locally available treatments and understanding reasons for their omission in CDS may increase perceived value, improve standardization, quality of cancer care and equity of care in China.