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Implementation of Patient Reported Outcomes in Outpatient Palliative Care: From Paper to Computer
David Hui1, Gustavo Scannapieco Mastroleo2, Aline Rozman De Morales1
1Department of Palliative (D.H., A.R.D-M., A.R., D.S.Z., M.J., E.B.), Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Background:
This quality improvement project aimed to transition completion of Edmonton Symptom Assessment System (ESAS) at our supportive care clinic from paper to electronic format.
Measures:
Proportion of patients who completed electronic ESAS (eESAS).
Intervention:
Starting July 2018, patients could complete eESAS 24h before check-in (eESAS-before), eESAS after check-in (eESAS-after) or on paper (pESAS).
Outcomes:
A total of 6631 cancer patients had 25,767 clinic visits between July 13, 2018 and November 5, 2021. The ESAS completion rate was 100%. eESAS uptake gradually increased over time, first reaching ≥75% eESAS completion in 5/2019 (eESAS-after 61.9%; eESAS-before 14.0%; pESAS 24.1%). We observed a sharp uptake in eESAS-before since adoption of telehealth during the pandemic (May 2020) and the ≥75% eESAS target was consistently achieved from November 2020 onwards (eESAS-after 0.6%; eESAS-before 76.7%; pESAS 22.7%). In an anonymous survey, we identified several modifiable barriers to implementing eESAS.
Conclusions:
Transition to eESAS was a gradual process and was catalyzed by the pandemic.
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