e-ICI is an electronic health record system which is a digital version of a patient’s paper chart. This system is real-time, information is available instantly, and patient centered, and securely to authorized users. The digital system helps care providers by minimizing time spent on manual documentation and allow access to evidence-based tools that providers can use to make decisions hence maximizing time for patient care.
With the rising cancer cases, there was need to digitize cancer centers within the counties providing care, patient information has all been captured manually on the patient chart. Due to this method of information collection, patient’s vital information was missing in the charts. This information could not be shared among various care providers and among facilities providing care within the country, especially referral facilities.

Since with e-ICI information is available whenever and wherever it is needed, there is need to interconnect more facilities providing cancer care. Providers will be able to access all patient information from any location (facility) hence there will be optimal cancer care and reduced manual patient chat movement hence improving care.

OBJECTIVE: Nigeria has one of the highest age-standardized breast cancer mortality rates worldwide, making implementation of breast cancer early diagnosis a priority. Early diagnosis requires accessible breast imaging and ultrasound (US)-guided biopsy capability, which is needed for cancer detection and tissue diagnosis. One barrier to early diagnosis is a major shortage of Nigerian radiologists trained to perform US-guided biopsies. To address this need, we developed a mobile health (mHealth) US-guided breast biopsy training program for radiologists. The purpose of this study was to evaluate preliminary implementation outcomes, including feasibility, acceptability, adoption, and sustainability, among a pilot cohort of program trainees.
METHODS: Radiology trainees (n=13) engaged in a 30-minute semi-structured interview after completing the program. Interviews elicited feedback on the course structure and barriers and facilitators to clinical implementation. Data were coded based on the implementation constructs of feasibility, acceptability, adoption, and sustainability, using a matrix analysis approach.
RESULTS: 1) Feasibility: The course’s e-learning modules facilitated flexible education, allowing participants to review and practice course material at their own pace. 2) Acceptability: All trainees would recommend the program to others; many felt the training enhanced their clinical skills and was relevant to their practice. 3) Adoption: Post-training, most radiologists felt confident independently performing US-guided breast biopsy in their own clinical practice. 4) Sustainability: Barriers to sustainable clinical implementation included lack of patient referrals, limited administrative support, and pathology delays. Facilitators included the adoption of a train-the-trainer model: many participants have already begun training residents at their Centers.
CONCLUSIONS: This pilot identified important implementation considerations for an mHealth US-guided breast biopsy training program to build capacity for breast cancer early diagnosis. Participants found the program feasible and acceptable. There is a need for feedback and support from the trainers during the clinical implementation phase, to help strategize ways to overcome site-specific barriers.

OBJECTIVE
Significant disparities exist in cancer outcomes world-wide. The Project ECHO modelTM (Extension for Community Healthcare Outcomes) reduces health disparities by creating technology enabled human networks to democratize implementation of specialized knowledge through guided practice. The aim of this study was to understand the impact of ECHO on the cancer workforce.

METHODS
The ECHO Institute launched a 5-year project to improve the capacity of local providers to bring cancer prevention, diagnostic, treatment, survivorship and palliative care knowledge to rural and underserved populations. Through ECHO’s all teach all learn model, local providers collaborate with experts at National Cancer Institute–designated Comprehensive Cancer Care Centers, academic medical centers and large nonprofit originations (hubs) for ongoing telementorship. Using a central data repository, we quantified the reach of the Cancer ECHO Initiative globally.

RESULTS
Since 2016, the ECHO model has been replicated by 85 hubs in 14 countries that are operating 155 cancer programs. This includes 7 hubs located in Africa, and many more programs dedicated to audiences on the continent. These 155 programs focused on diverse cancer prevention and treatment topics, including increasing clinical trial enrollment, cancer control and research, tobacco cessation, cancer care during COVID-19, survivorship, palliative care, organizational strengthening and more. Globally, we observed 43,000 Cancer ECHO attendances with over 8,000 unique learners. To date, 39 peer-reviewed publications have documented the ECHO model’s efficacy in improving the use of best practices in cancer care and expanding access to care in low-resource settings.

CONCLUSIONS
The ECHO model is successfully strengthening the cancer health system and accelerating the transmission of best practice cancer care from cancer centers to health care workers in underserved communities. Ongoing evaluation of the Cancer ECHO program will provide insight around the impact of this initiative.

Implementation science is an emerging field of study that seeks to bridge the research-to-practice gap via integration of research findings and other evidence-based practices into routine care and services. Implementation science is a rather new field that addresses an old question: How is research translated into practice? Implementation science in resource-poor countries and communities offers important opportunities for future discoveries and reverse innovation. However, it is one field in which the continent is lagging behind in as most of the current activities taking place are in South Africa and in Uganda. The Prostate Cancer Transatlantic Consortium (CaPTC) is filling this gap by forming the Implementation science team, through the African Behavioural Research Center under the leadership of Dr. Catherine Oladonyinbo and Dr. Ernest Kaninjing. Seven Vibrant groups consisting of Clinicians, basic scientists, behavioural scientists and policy makers (drawn from Nigeria, Cameroun and Ghana) have been formed. All members of the groups have training course on Dissemination and Implementation Research, from the National Cancer Institute in the United States. The Training Institute for Dissemination and Implementation Research in Cancer (TIDIRC) offers six modules that provide an overview to dissemination and implementation (D&I) research. Each module serves as an introduction to the fundamental terms, concepts, and principles of D&I with examples of their application. The modules include videos, additional resources and reading. All groups have formulated pilot projects which will be presented during this conference and those judged worthy will be awarded pilot funding by the founder and overall PI of CaPTC Prof. Folakemi Odedina. it is hoped that the Implementation Science group grows to a point where it becomes self-sustaining through grants and funding and perhaps blossoms into a full-fledged Master’s programme domiciled at one of the CaPTC sites.

In Kenya cancer is an increasing public health challenge, with an estimated 48,000 new cancer cases and over 33,000 deaths recorded each year. Machakos county, Kenya, recently opened a cancer center given the increasing burden of cancer care with an aim of bringing cancer services such as surgical oncology, chemotherapy, radiotherapy, and pathological services closer to the residents of Machakos county. The county is also one of four counties selected for the universal health coverage pilot programme making it uniquely poised to inform cancer control programs at the local, national, and international levels. This study aimed to build a cancer database and comprehensively to enable future population-based cancer studies by reviewing cancer diagnosis records for selected major public hospitals in Machakos county from 2015-2019. Medical records data were retrieved from Machakos Level 5 Hospital and Kangundo, Matuu, Kathiani and Mwala Level 4 Hospitals. A total of 522 cancer cases were recorded across the study period with more than a third (N=172, 33%) diagnosed August-December of 2019 when the Machakos Cancer Centre opened. Among the cancers diagnosed the majority were in women (59.2%) with cervix uteri (n=106, 34.3%) followed by breast (n=62, 20.1%) as the most common cancers. For males, oesophagus (n=52, 24.4%) followed by prostate (n=43, 20.2%) were the most common cancer types. It is clear that access to cancer care treatment will change referral patterns for residents in Machakos county and with the establishment of this database we expect to enable future population-based surveillance of the cancer burden to inform cancer control programs.