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Health Information Technology and Healthcare Information System01:30

Health Information Technology and Healthcare Information System

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Health Information Technology (HIT)
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Using Quality Improvement and Implementation Science to Identify Strategies That Foster Electronic Patient-Reported

James W Doolin, Samira L Dias, Christine Cronin

    Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
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    PubMed
    Summary

    Direct patient outreach significantly improved electronic patient-reported outcomes (ePRO) submission rates in cancer symptom management. This highlights the effectiveness of targeted communication for enhancing ePRO utilization in clinical settings.

    Keywords:
    electronic patient reported outcomesimplementation strategieskey performance indicatorsquality improvementstatistical process control charts

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    Area of Science:

    • Oncology
    • Health Services Research
    • Digital Health

    Background:

    • A pragmatic type-II hybrid effectiveness-implementation study evaluated an electronic patient-reported outcomes (ePRO)-based symptom management program (eSyM).
    • Six cancer centers collected performance indicators and implementation strategies to understand ePRO deployment in routine care.
    • The study aimed to identify strategies linked to variations in weekly ePRO submission rates.

    Purpose of the Study:

    • To identify implementation strategies associated with significant changes in weekly electronic patient-reported outcomes (ePRO) submission rates.
    • To inform the broader deployment of ePROs within routine cancer care settings.

    Main Methods:

    • Utilized statistical process control (SPC) methodology to detect periods of special cause variation in ePRO submission rates across six cancer centers.
    • Collected ePRO utilization rates and implementation strategies over 714 weeks (August 2019-April 2022).
    • Identified implementation strategies temporally linked to detected variations in ePRO submission.

    Main Results:

    • Mean weekly ePRO response rate was 22.3%, with considerable site-to-site variability.
    • SPC charts identified multiple instances of special cause variation across all participating centers.
    • Direct patient outreach strategies, focused on education and encouragement, showed the strongest association with positive variations in ePRO submission rates.

    Conclusions:

    • Direct patient outreach positively impacts ePRO responsiveness, offering a key strategy for improving cancer symptom management.
    • Quality improvement techniques like SPC charting can aid the implementation of complex interventions.
    • Findings suggest tailoring ePRO implementation to specific patient populations and healthcare systems is crucial.