Implementation of a cloud-based electronic patient-reported outcome (ePRO) platform in patients with advanced cancer
| Autor: | Sukhmani K. Padda, Touran Fardeen, George A. Fisher, Tyler Johnson, Gilbert Chu, Bianca Bruzzone, Brianna Velazquez, Gregory M. Heestand, Olga Generalova, Sigurdis Haraldsdottir, Sandy Srinivas, Kristen M. Cunanan, Mohana Roy, Robert W. Hsieh, Joel W. Neal, Heather A. Wakelee, Sumit A. Shah, Evan T. Hall, Anna Cabot, Kavitha Ramchandran, Alice C. Fan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Quality of life
Care-delivery Healthcare utilization business.industry Short Report Health Informatics Cloud computing Usability Disease Electronic patient-reported outcome medicine.disease law.invention Quality of life (healthcare) Health Information Management Randomized controlled trial law Phone Ambulatory medicine Medical emergency Public aspects of medicine RA1-1270 business Patient reported outcomes |
| Zdroj: | Journal of Patient-Reported Outcomes Journal of Patient-Reported Outcomes, Vol 5, Iss 1, Pp 1-11 (2021) |
| ISSN: | 2509-8020 |
| DOI: | 10.1186/s41687-021-00358-2 |
| Popis: | Background Patient reported outcomes (PROs) have been associated with improved symptom management and quality of life in patients with cancer. However, the implementation of PROs in an academic clinical practice has not been thoroughly described. Here we report on the execution, feasibility and healthcare utilization outcomes of an electronic PRO (ePRO) application for cancer patients at an academic medical center. Methods We conducted a randomized trial comparing an experimental ePRO arm to standard of care in patients with advanced cancer in the thoracic, gastrointestinal, and genitourinary oncology groups at Stanford Cancer Center from March 2018 to November 2019. We describe the pre-implementation, implementation, and post-implementation phases of the ePRO arm, technological barriers, electronic health record (EHR) integration, clinician burden, and patient data privacy and security. Feasibility was pre-specified to be at least 70% completion of all questionnaires. Acceptability was based on patient and clinician feedback. Ambulatory healthcare utilization was assessed by reviewing numbers of phone messages, electronic portal messages, and referrals for supportive care. Results Of 617 ePRO questionnaires sent to 72 patients, 445 (72%) were completed. Most clinicians (87.5%) and patients (93%) felt neutral or positive about the ePRO tool’s ease of use. Exposure to ePRO did not cause a measurable change in ambulatory healthcare utilization, with a median of less than two phone messages and supportive care referrals, and 5–6 portal messages. Conclusions Web-based ePRO tools for patients with advanced cancer are feasible and acceptable without increasing clinical burden. Key lessons include the importance of pilot testing, engagement of stakeholders at all levels, and the need for customization by disease group. Future directions for this work include completion of EHR integration, expansion to other centers, and development of integrated workflows for routine clinical practice. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink