Perceptions of an Electronic Patient Symptom Reporting Tool by Clinicians

Prior to implementing an electronic health record-integrated patient-reported outcomes system, eSyM, the perceived facilitators and barriers to implementation from multiple stakeholder perspectives were sought. The purpose is to report the findings of the perceived facilitators and barriers to implementation of eSyM from multiple clinician stakeholder perspectives. Stakeholders included administrators, clerical staff, information technology professionals, support staff, physicians, providers, and nurses from six Symptom Management Implementation of Patient-Reported Outcomes in Oncology health systems, a diverse mix of academic/community, rural/metropolitan, and Northeastern and Southern community-based cancer centers. Site information, participant information, perceived effectiveness, and perceived patient barriers to use were collected from 173 stakeholders. RNs were the most represented participants, followed by physicians, physician assistants, and nurse practitioners. Stakeholders felt that eSyM would be effective in improving patient symptom management, keeping patients out of the hospital and emergency department, and improving clinic efficiency. Clinician stakeholders perceived eSyM as necessary and effective for improving symptom management. Most stakeholders felt that their colleagues would be supportive of using eSyM. Stakeholders perceived minor patient barriers were access to technology, distrust of technology, and English language proficiency. Computer literacy was perceived as a major barrier. Future longitudinal mixed-methods design that combines quantitative findings with qualitative observations is needed. Understanding the contextual factors that influence the facilitation or barriers of implementing eSyM is needed to scale and spread the intervention to other institutions. As a nursing intervention, the assessment of the perceptions of improvement of eSyM workflow would be especially useful.