Background
Recent guidelines suggest using primary human papillomavirus (HPV) screening for cervical cancer. However, there is limited guidance on how to effectively implement this change in practice. This study compared two approaches: one that is centrally administered with local adjustments and another that is centrally administered with standard care.
Methods
This study was conducted within the Kaiser Permanente Southern California health system from 2020 to 2022. We randomly assigned different service areas to either the locally-tailored approach or the standard approach. The locally-tailored approach involved assessing local needs and customizing the implementation strategies accordingly. We measured the success of these approaches by looking at the proportion of primary HPV screenings and gathering feedback from patients and providers through surveys and health records.
Results
Both approaches resulted in a high proportion of primary HPV screenings: 98.4% for the locally-tailored group and 99.1% for the centrally-administered group. There were no significant differences in patient and provider satisfaction or knowledge between the two groups.
Conclusions
Both implementation strategies effectively increased the use of primary HPV screening in the health system. The locally-tailored approach did not outperform the centrally-administered approach in terms of stakeholder satisfaction. However, the results may not apply to other health systems due to the unique nature of the integrated health system used in this study.
Opportunities for Improvement
Based on the trial data, healthcare providers can:
- Define Measurable Outcomes: Set clear goals for implementing primary HPV testing in clinics and for patients.
- Select AI Tools: Choose AI solutions that meet specific clinical needs for better implementation.
- Implement Step by Step: Start with a pilot project and track results using AI solutions to measure real-world impact.
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