This project was designed as an implementation research and quality improvement initiative, focusing on healthcare process innovation rather than experimental therapeutic intervention. It did not involve randomization or changes to patient treatment protocols. In line with international guidance on quality improvement and health system strengthening activities, the project was deemed exempt from formal ethical review by the institutional review board, as it constituted a system-level improvement without direct patient intervention [17][18].

The project was led by the Institut de Prévoyance Médico-Social (IPMS) at Cheikh Anta Diop University in Dakar and implemented by a multidisciplinary team comprising oncology specialists, health informatics experts, and healthcare administrators. Financial support was provided through a grant from Pfizer, which covered technology development, training activities, and project coordination. Implementation involved multiple oncology care sites, including tertiary hospitals in Dakar and selected regional hospitals, ensuring representation across different levels of the Senegalese health system. The project officially began on January 15, 2024, with a planned duration of approximately two years for pilot implementation and evaluation, followed by potential scale-up.

A comprehensive needs assessment and gap analysis were conducted at project inception. National cancer epidemiology and health system data from WHO and GLOBOCAN were reviewed to establish baseline conditions [1]-[4]. These data confirmed that cancer is a leading and growing cause of mortality in Senegal and that oncology services face significant capacity constraints.

In parallel, semi-structured interviews and surveys were conducted with oncologists, surgeons, radiologists, pathologists, pharmacists, and healthcare administrators. Key challenges identified included difficulty coordinating in-person MCCMs due to geographic dispersion of specialists, high clinical workloads, and limited oncology workforce outside Dakar. Participants also highlighted the absence of standardized mechanisms for case data sharing, documentation, and follow-up, which hindered continuity and quality of care. These findings are consistent with prior reports on cancer care delivery challenges in sub-Saharan Africa [3][4][16].

The needs assessment confirmed a strong rationale for a digital MCCM platform capable of enabling virtual collaboration, reducing time and cost burdens, and creating a structured electronic record of multidisciplinary discussions. It also helped define target metrics, including engagement of 85 healthcare professionals nationwide and indirect benefit to hundreds of cancer patients through more timely and coordinated treatment planning.

The core intervention was the development of a centralized, secure, web-based digital platform specifically designed for MCCMs. The platform allowed authorized healthcare professionals to access patient case information, participate in real-time or asynchronous discussions, schedule meetings, and archive decisions. Data security and patient confidentiality were prioritized through role-based access control, encrypted data transmission, and secure hosting, in accordance with international best practices in health information security [19][20].

The digital MCCM platform was developed as a web-based application using an open-source technology stack, primarily built with React.js for the frontend, Node.js for the backend, and MongoDB for the database. The system was designed to be lightweight, scalable, and accessible via both desktop and mobile devices through standard web browsers. It currently functions as a standalone tool and does not yet integrate directly with existing Electronic Medical Record (EMR) systems in Senegal, as most participating facilities operate with heterogeneous or limited digital infrastructure. However, the platform’s architecture includes standardized APIs (Application Programming Interfaces) to enable future interoperability with EMRs or national health information systems, should such integration become feasible. This modular design allows for future scaling and data exchange without requiring complete.

Development followed an agile, iterative methodology, with continuous input from end-users. Prototypes were tested in simulated MCCM scenarios and refined based on clinician feedback. Pilot testing ensured usability, reliability, and alignment with real-world workflows before broader deployment.

The rollout followed a phased implementation strategy encompassing initiation, needs assessment, design and development, pilot implementation, and planned scale-up. Training and capacity building were integral components, with hands-on workshops and simulated case discussions to ensure effective adoption. Evaluation combined quantitative usage metrics and qualitative user feedback, consistent with established frameworks for digital health and quality improvement evaluation [17][21].

The digital MCCM platform was successfully developed and deployed at the designated pilot sites according to the project timeline. By the end of the pilot phase, the platform was fully operational and actively used for real-world multidisciplinary cancer case discussions.

A total of 45 healthcare professionals were onboarded and actively using the platform during the pilot phase, representing approximately 53% of the initially targeted national oncology workforce (n = 85). Participants included all 15 practicing oncologists based in Dakar, as well as specialists from regional hospitals, including surgeons, radiologists, pathologists, oncology nurse specialists, and pharmacists involved in cancer care.

Figure 1 presents a comparative overview of MCCM implementation indicators before and after digitalization.

Figure 1. Comparison of digital MCCM implementation.

The platform enabled MCCM sessions that connected specialists from multiple institutions simultaneously. On average, 5 - 6 specialists from different disciplines participated in each case discussion. This multidisciplinary composition was consistently achieved across sessions, reflecting the platform’s ability to overcome geographic and scheduling barriers that previously limited participation.

Early usage patterns indicated an increase in the frequency of MCCMs at pilot sites. Several centers transitioned from monthly in-person tumor boards to weekly virtual meetings, facilitated by the reduced logistical burden of virtual scheduling. Additionally, the platform enabled ad-hoc MCCMs for urgent cases, which could be organized within days rather than waiting for the next scheduled physical meeting. While comprehensive quantitative measures of time savings are still under analysis, clinicians consistently reported that coordination timelines were reduced from “weeks” to “a few days” in some cases, suggesting improved responsiveness in clinical decision-making.

Implementation of the digital MCCM platform resulted in a marked improvement in multidisciplinary collaboration and communication. Feedback from participating clinicians consistently highlighted enhanced efficiency, clarity, and quality of case discussions.

The platform centralized all relevant patient information—including imaging, pathology reports, and clinical summaries—allowing participants to review data in advance or during meetings. This represented a substantial improvement over prior practices, where information was often fragmented across paper files, disparate systems, or verbal summaries. Real-time discussion tools enabled specialists to clarify details concurrently, reducing miscommunication and the need for follow-up interactions outside the meeting.

Clinicians reported that decisions were reached more rapidly and with greater confidence, supported by comprehensive data availability and simultaneous multidisciplinary input. For example, in one breast cancer case, specialists located at different hospitals collectively reviewed imaging and pathology and agreed on a treatment plan within a single virtual MCCM. Previously, such coordination would have required additional steps or delayed in-person meetings.

Beyond efficiency, the platform fostered a stronger sense of shared responsibility for patient management. Specialists described a shift toward more integrated, team-based decision-making, with reduced professional silos. One senior oncologist summarized this transformation by noting that the platform effectively functioned as a “national tumor board,” enabling expert input from regional cities without requiring travel.

Importantly, the platform’s documentation and archival features significantly improved the traceability of decisions. All MCCM recommendations were recorded digitally, providing a clear and accessible reference for implementation and follow-up. This enhanced accountability and continuity of care, replacing prior reliance on handwritten notes or informal recollection.

The project contributed substantially to capacity building in digital health among oncology professionals. By the end of the pilot phase, all active users had received hands-on training and practical exposure to the platform. Most participants reported high confidence in navigating the system after initial training sessions.

Several users progressed beyond basic use, independently exploring advanced features such as case filtering by tumor type and exporting meeting summaries. Informal peer mentoring emerged, with experienced users supporting colleagues, further reinforcing adoption. Notably, even senior clinicians who initially expressed hesitation toward virtual meetings reported positive attitudes after experiencing the platform’s benefits.

The training and subsequent platform use fostered a broader shift toward digital practices in daily clinical work. Clinicians reported increased use of secure digital communication for interdisciplinary consultations outside formal MCCMs, attributing this behavioral change to the project. The platform also began to function as a learning environment, with archived case discussions forming a repository for education and knowledge sharing, laying the groundwork for future structured continuing professional development activities.

Data security was a central component of platform implementation. Throughout the pilot phase, no data breaches or unauthorized access incidents were reported. Secure authentication, role-based access control, and encryption of data at rest and in transit were consistently applied.

Clinician confidence in data protection increased over time. Initial concerns regarding confidentiality were alleviated through demonstrations of security features and observed system reliability. This trust was reflected in users’ willingness to enter detailed patient information into the platform, a critical factor for effective MCCMs.

Beyond technical safeguards, the project reinforced ethical data-handling practices. Training sessions emphasized confidentiality and discouraged use of unsecured communication channels for patient information. As a result, the project not only protected patient data but also strengthened awareness of professional responsibility in digital health contexts.

All planned activities for Phases 1 - 4 (planning, needs assessment, platform development, and pilot deployment) were completed on schedule. The pilot phase began in October 2024 as planned, reflecting effective project governance and coordination.

No major implementation barriers were encountered. Anticipated risks such as resistance to change, technical issues, or infrastructure limitations were mitigated through early stakeholder engagement, strengthening of IT infrastructure, and responsive technical support. Minor technical issues, such as initial login difficulties, were resolved promptly without disrupting platform use.

While it is too early to assess patient-level outcomes such as survival or disease control, the interim results indicate a strong foundation for impact. Improved timeliness of decision-making, broader specialist participation, and enhanced coordination suggest a high likelihood of downstream benefits in treatment initiation and adherence to multidisciplinary recommendations. Importantly, the platform has begun to address inequities in access to expert consultation, particularly for patients managed outside Dakar.

User feedback was overwhelmingly positive. Healthcare professionals described the platform as making MCCMs “more structured,” “more inclusive,” and “less chaotic” than traditional meetings. Several specialists emphasized that virtual participation enabled them to contribute expertise that was previously underutilized due to scheduling or geographic constraints.

The initiative was widely perceived as a major advancement in cancer care organization in Senegal. Interest from other clinical departments in adopting similar tools for complex case discussions further suggests the platform’s perceived value and scalability. Collectively, these findings indicate strong user satisfaction and a favorable environment for sustained use and future expansion.

This study demonstrates that the digitalization of multidisciplinary tumor board meetings is feasible and beneficial in a low-resource setting like Senegal. The main findings include a high level of adoption and engagement by healthcare professionals, with more than half of the country’s oncology specialists actively using the MCCM platform in the pilot stage; clear improvements in collaboration and efficiency of case discussions and the successful implementation of a secure, tailored digital tool in the healthcare workflow, evidenced by positive user feedback and the absence of major implementation hurdles.

These results collectively indicate that introducing a well-designed digital platform can effectively address the challenges that were previously impeding optimal MCCM function (such as scheduling difficulties, communication gaps, and lack of documentation). Moreover, the project’s emphasis on training and iterative refinement has been validated by the smooth uptake and user competence observed—healthcare providers not only accepted the new system but became proficient in its use, an important outcome for long-term sustainability.

Another key finding is the strong positive reception and perceived value of the platform among users, who view it as a significant advancement in how cancer care is coordinated in Senegal. While long-term patient outcome data are not yet available at this interim stage, the foundation has been laid for improved clinical care processes that should logically translate into better outcomes (for instance, through timely initiation of appropriate treatments). Overall, the project’s main takeaway is that digital transformation of multidisciplinary care processes is both achievable and impactful even in resource-constrained environments when it is guided by local needs and accompanied by proper support and training.

Our findings align with and reinforce observations from other healthcare settings regarding the benefits of digital or virtual multidisciplinary collaboration. The enhanced efficiency, improved communication, and broader specialist participation enabled by the MCCM platform in Senegal mirror results reported from digital tumor board implementations in other countries. For example, a cloud-based asynchronous MDT platform implemented in China demonstrated a significant increase in the number of patients discussed and improved adherence to clinical guidelines compared with traditional in-person MDT meetings [22]. Similarly, studies from high-income settings have shown that virtual tumor boards can expand specialist input, reduce delays, and improve documentation without compromising decision quality [12][14].

Although our project is at an earlier stage, preliminary observations suggest that more cases, including those from outside Dakar, can be reviewed by multidisciplinary experts because the platform reduces geographical and scheduling constraints. Improved communication, with all relevant clinical data centralized and easily accessible, echoes findings from other virtual tumor board studies that reported more structured discussions and time savings [11][13][14].

Notably, we encountered minimal resistance from users. This acceptance likely reflects the platform’s clear value proposition in addressing challenges already recognized by clinicians, such as delays in coordinating meetings and difficulty accessing specialist input. Early and continuous stakeholder engagement, combined with targeted training, appears to have played a critical role in facilitating adoption. This observation is consistent with implementation science literature, which emphasizes the importance of involving end-users early and throughout the development process to ensure acceptability and sustainability of health technology innovations [23][24].

The absence of major barriers during rollout is an encouraging signal. Common challenges in health information technology projects—such as technical failures, workflow disruption, or user resistance—were largely avoided. This outcome likely reflects robust planning, context-appropriate design, and strong institutional support. By tailoring the platform to existing MCCM workflows and prioritizing usability and security, potential trust and usability concerns were mitigated. The project also benefited from clear institutional commitment and grant-based support, which facilitated mobilization of resources and stakeholder cooperation.

An important interpretive finding is the observed cultural shift toward acceptance of digital solutions. Initial skepticism among some users evolved into enthusiasm as the platform’s advantages became evident. This challenges assumptions that resistance to change is inevitable in LMIC settings and supports evidence that healthcare professionals will embrace digital innovation when it demonstrably improves their work and patient care [25]. It also reflects the growing readiness for digital health adoption in Africa, where many clinicians are already familiar with digital tools in personal communication, making professional use a natural extension when appropriately supported.

Nonetheless, these interim results must be interpreted with caution. The ultimate test of success will be whether process improvements translate into measurable improvements in patient outcomes and whether sustained platform use continues beyond the pilot phase. While MDT-based care has been associated with improved treatment decisions and outcomes, digital tools must add value beyond traditional in-person MDTs. In the Senegalese context, where many patients previously lacked access to full multidisciplinary review, the digital platform effectively extends MDT expertise to underserved areas—a mechanism that is likely to improve quality of care by reducing inequities in access to specialist input. This interpretation aligns with the broader goals of telemedicine and digital health initiatives aimed at democratizing access to expertise [10][16].

Finally, the project’s strong emphasis on data security and patient privacy is interpreted as a critical success factor. Trust in digital systems is essential, and any breach could rapidly undermine stakeholder confidence. Overall, these results support the conclusion that technology-enabled multidisciplinary collaboration can overcome traditional barriers in cancer care delivery in low-resource settings. The project provides a real-world example that may inform policy and practice not only in Senegal but also in other countries seeking to modernize cancer care coordination through digital innovation.

The success of this digital MCCM project carries several important implications.

Firstly, for healthcare delivery in Senegal, it demonstrates a viable pathway to strengthen oncology services through digital innovation. The platform can be seen as a prototype for how other collaborative clinical processes (not just in oncology, but also in other specialties with multidisciplinary needs) might be improved. For instance, similar platforms could be extended to handle complex cases in cardiology or pediatrics that require input from multiple specialists. The implication for patients is potentially profound: if the model is adopted widely, patients across Senegal—including those in remote or under-resourced areas—could routinely benefit from the collective expertise of a national panel of specialists without the need for referral travel, thereby bringing more equitable care. For the healthcare system, this project suggests a means to optimize resource use; by reducing travel and meeting costs and by enabling more efficient case management, scarce specialist time can be utilized more effectively and more patients can be served.

Secondly, there are implications for health policy and planning. The positive outcomes provide evidence to policymakers and hospital administrators that investing in digital health infrastructure can yield tangible improvements in care coordination. It could inform national cancer control strategies by incorporating digital MDT meetings as a standard component. Additionally, the model is potentially replicable in other low- and middle-income countries (LMICs) facing similar challenges. Many sub-Saharan African countries have a limited number of specialists concentrated in urban centers, and patients in peripheral regions often do not benefit from multidisciplinary input. A secure digital MCCM approach could be a scalable solution in those contexts as well. The lessons learned in Senegal—such as the importance of user training, stakeholder engagement, and robust IT support—can guide other implementations. We anticipate sharing our experiences through regional networks and publications (as planned in the dissemination phase), thereby contributing to a knowledge base for digital health interventions in oncology.

Another implication is in the realm of continuous professional education and collaboration. The project created a virtual community of practice for Senegal’s oncology professionals. Over time, this could evolve into a platform for not only case discussions but also for mentoring, knowledge exchange, and even research collaborations. We have essentially laid the foundation for an oncology tele-network that could support multi-center clinical trials or standardization of care protocols by facilitating communication. The implication is that digitalizing MCCMs has benefits beyond individual patient management—it can elevate the entire practice of oncology by keeping specialists connected.

Lastly, on a global scale, this project adds to the growing evidence that digital health solutions can be effectively implemented in LMIC health systems when they address clearly identified needs and when they are backed by adequate support. It underscores the importance of contextual design: a solution that is built taking into account local constraints (like limited internet bandwidth in some regions, or varying levels of tech-savvy among users) stands a better chance of success. Going forward, our results imply that further scaling and sustainability will depend on continuous support and possibly integration with existing health information systems. As a result, we are in discussions with the Ministry of Health about how the MCCM platform might interface with the national e-health strategy (for example, linking with electronic medical record systems or national cancer registries). The broader implication is that such projects should not remain stand-alone pilots; rather, they should be integrated into the health system and scaled up with government buy-in for maximum impact.

To ensure sustainability beyond the initial grant period, a transition plan is being developed to shift the financial responsibility for server hosting, technical maintenance, and user support to national stakeholders. Discussions are underway with the Ministry of Health and pilot hospitals to allocate part of their operational budgets to support the platform’s ongoing costs. The proposed model includes incorporating platform expenses into annual hospital IT budgets and exploring integration into national eHealth initiatives. This approach aims to institutionalize the platform as part of routine oncology service delivery, reducing dependence on external funding and reinforcing long-term scalability.

Several elements contributed to the success and credibility of this initiative. First, the platform was designed in direct response to clearly identified needs in cancer care coordination, ensuring that it addressed a concrete and locally relevant gap. This grounded, demand-driven approach enhanced both relevance and uptake among healthcare providers. Furthermore, the early and continuous involvement of end-users—clinicians from multiple specialties—was critical. Their input shaped the platform’s functionalities and workflows, resulting in a tool that was intuitive, aligned with clinical realities, and embraced by its users.

The project also benefited from a structured, phased implementation with strong project management. Clear milestones allowed for effective resource allocation and continuous monitoring, enabling timely adaptation and preventing major delays. Capacity building was another core strength: the integration of digital literacy training empowered participating clinicians to engage meaningfully with the technology and positioned them for future eHealth initiatives. Importantly, the platform was built with rigorous attention to data protection, adhering to recognized standards of privacy and security—an essential factor in maintaining trust and ethical compliance in healthcare settings. Finally, the initiative represented a pioneering effort in the West African context, offering a novel, contextually adapted solution that demonstrates the feasibility of digitalizing multidisciplinary care even in resource-limited environments.