Implementation Strategy for Artificial Intelligence in Radiotherapy: Can Implementation Science Help?

Abstract

Purpose: Artificial intelligence (AI) applications in radiotherapy (RT) are expected to save time and improve quality, but implementation remains limited. Therefore, we used implementation science to develop a format for designing an implementation strategy for AI. This study aimed to (1) apply this format to develop an AI implementation strategy for our center; (2) identify insights gained to enhance AI implementation using this format; and (3) assess the feasibility and acceptability of this format to design a center-specific implementation strategy for departments aiming to implement AI.

Methods: We created an AI-implementation strategy for our own center using implementation science methods. This included a stakeholder analysis, literature review, and interviews to identify facilitators and barriers, and designed strategies to overcome the barriers. These methods were subsequently used in a workshop with teams from seven Dutch RT centers to develop their own AI-implementation plans. The applicability, appropriateness, and feasibility were evaluated by the workshop participants, and relevant insights for AI implementation were summarized.

Results: The stakeholder analysis identified internal (physicians, physicists, RT technicians, information technology, and education) and external (patients and representatives) stakeholders. Barriers and facilitators included concerns about opacity, privacy, data quality, legal aspects, knowledge, trust, stakeholder involvement, ethics, and multidisciplinary collaboration, all integrated into our implementation strategy. The workshop evaluation showed high acceptability (18 participants [90%]), appropriateness (17 participants [85%]), and feasibility (15 participants [75%]) of the implementation strategy. Sixteen participants fully agreed with the format.

Conclusion: Our study highlights the need for a collaborative approach to implement AI in RT. We designed a strategy to overcome organizational challenges, improve AI integration, and enhance patient care. Workshop feedback indicates the proposed methods are useful for multiple RT centers. Insights gained by applying the methods highlight the importance of multidisciplinary collaboration in the development and implementation of AI.