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E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Remote Symptom Monitoring With Electronic Patient-Reported Outcomes in Clinical Cancer Populations.

Gabrielle B Rocque^1,2,3, Jeffrey A Franks¹, Luqin Deng³

¹Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham.

JAMA Network Open

|May 13, 2025

Summary

Remote symptom monitoring (RSM) using electronic patient-reported outcomes reduced hospitalizations by 19% at 3 months and 13% at 6 months for cancer patients. This supports broader implementation of RSM in cancer care.

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Area of Science:

Oncology
Health Services Research
Digital Health

Background:

Value-based healthcare models increasingly rely on remote symptom monitoring (RSM) for patients with cancer to optimize healthcare utilization.
However, empirical data on the real-world clinical impact of RSM remains limited.

Purpose of the Study:

To assess the association between RSM, utilizing electronic patient-reported outcomes, and healthcare utilization (hospitalizations, ICU admissions, ED visits) at 3 and 6 months.
To evaluate the effectiveness of RSM in a diverse patient population receiving systemic cancer therapy.

Main Methods:

A nonrandomized controlled trial with a hybrid Type 2 implementation-effectiveness design was conducted.
Patients receiving systemic cancer treatment were assigned to either standard care with RSM (2021-2024) or historical controls (2017-2021).
Health care utilization outcomes were analyzed using adjusted modified Poisson and penalized logistic regression models.

Main Results:

RSM was associated with a significant reduction in hospitalizations: 19% at 3 months (RR, 0.81; 95% CI, 0.73-0.91) and 13% at 6 months (RR, 0.87; 95% CI, 0.80-0.96).
No significant differences in ICU admissions or ED visits were observed between the RSM group and historical controls.
Subset analyses indicated consistent patterns across different patient demographics and socioeconomic factors.

Conclusions:

Implementation of RSM in patients with cancer is associated with a reduced risk of hospitalization.
These findings underscore the potential of RSM to improve healthcare efficiency and support its wider adoption in oncology care nationally.