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Feasibility of Weekly Electronic Health Record-Embedded Patient-Reported Outcomes for Patients Starting Oral
Jim W Doolin1, Ellana K Haakenstad1, Bridget A Neville2
1Department of Quality and Patient Safety, Dana-Farber Cancer Institute, Boston, MA.
JCO Clinical Cancer Informatics
|October 3, 2023
Summary
Integrating electronic patient-reported outcomes into electronic health records for oral cancer therapy was feasible but had low completion rates. Prompting nurses for severe symptoms did not significantly improve patient engagement.
Area of Science:
- Oncology
- Digital Health
- Symptom Management
Background:
- Oral cancer-directed therapy (OCDT) requires robust symptom management.
- Integrating electronic patient-reported outcomes (ePROs) into electronic health records (EHRs) offers a potential solution for real-time monitoring.
- The role of oncology nurse navigators (ONNs) in responding to severe symptomatic adverse events (SAEs) needs further investigation.
Purpose of the Study:
- To assess the feasibility of embedding an ePRO platform within an EHR for patients undergoing OCDT.
- To evaluate the impact of alerting ONNs to SAEs identified through ePROs.
- To explore patient engagement with ePROs during OCDT.
Main Methods:
- A prospective study involving 100 adult patients receiving OCDT.
- Participants were assigned to either a passive (P) or active (A) group.
- The active group received alerts for ONN outreach upon reporting severe SAEs; the passive group did not.
Main Results:
- Feasibility was defined as completing at least two ePROs within 30 days; 45% in the active group and 57% in the passive group met this threshold (P = .26).
- ePRO completion rates and documented telephone encounters were similar between the active and passive groups at 30 days.
- Overall, ePRO completion was feasible but many entries remained incomplete.
Conclusions:
- Weekly ePROs integrated into EHRs are feasible for patients on OCDT, but completion rates require improvement.
- Actively prompting ONNs for SAEs did not significantly enhance ePRO completion or patient engagement in this study.
- Future research should focus on strategies to improve patient engagement and proactive symptom management.
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