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Strategies for Implementing an Electronic Patient-Reported Outcomes-Based Symptom Management Program Across Six

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Summary

Implementing electronic patient-reported outcomes (ePROs) in cancer care requires strategic planning. This study identified universal, high-impact strategies that successfully integrated ePRO symptom management into routine oncology and surgery settings.

Keywords:
Consolidated Framework for Implementation Research (CFIR)Expert Recommendations for Implementing Change (ERIC)Implementation scienceImplementation strategySymptom managementePROs (electronic patient-reported outcomes)

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Area of Science:

  • Oncology
  • Health Services Research
  • Digital Health

Background:

  • Electronic patient-reported outcomes (ePROs) enhance cancer patient outcomes but face implementation challenges.
  • These challenges include technical integration, stakeholder buy-in, workflow adaptation, and institutional investment.

Approach:

  • The SIMPRO Research Consortium developed and deployed eSyM, an electronic health record-integrated ePRO symptom management program across six cancer centers.
  • Implementation strategies were documented monthly using REDCap, categorized using the Expert Recommendations for Implementation Change (ERIC) list, and mapped to barriers using the Consolidated Framework for Implementation Research (CFIR).

Key Points:

  • 226 implementation strategies were documented, with 64 unique site-developed strategies categorized as 'universal' (N=29) or 'adaptive' (N=35).
  • Universal strategies, consistently used across multiple sites, were perceived as having the highest impact, focusing on clinical preparation, training, patient/clinician engagement, and program evaluation.
  • The study addressed 44 out of 73 ERIC strategies and all 5 CFIR barriers.

Conclusions:

  • Systematic collection of theory-based implementation strategies identified high-impact universal strategies crucial for adopting novel care-delivery interventions.
  • These findings can guide other institutions in implementing ePROs for routine cancer care symptom management.