Framework for integrating electronic patient-reported data in routine cancer care: an Oncology Intake Questionnaire. Issue 3 (26th July 2022)

• Record Type: Journal Article
• Authors: McCleary, Nadine J; Haakenstad, Ellana K; Cleveland, Jessica L F; Manni, Michael; Hassett, Michael J; Schrag, Deb
• Is Part Of: JAMIA open. Volume 5:Issue 3(2022)
• Publication Date: 2022-07-26
• Subjects: patient-reported outcomes -- patient-reported data -- electronic patient-reported outcomes -- intake questionnaire -- questionnaire implementation; Medical informatics -- Periodicals; 610.285
• DOI: 10.1093/jamiaopen/ooac064
• Languages: English
• ISSNs: 2574-2531

Abstract

Abstract: Objective: As part of ongoing implementation of electronic patient-reported outcome tools at the Dana-Farber Cancer Institute, here we describe the development of the electronic New Patient Intake Questionnaire. Materials and Methods: The original New Patient Intake Questionnaire includes a review of symptoms, oncology history, family history, health behaviors, health and social status, health literacy and numeracy, which was modified for integration into the EHR using content determination, build and configuration, implementation, analytics, and interventions. The engagement of key stakeholders, including patients, clinical staff, and providers, throughout the development and deployment of the electronic Questionnaire was crucial to producing a successful tool. Continual modifications based on input of stakeholders (such as mode of tool deployment) were made to ensure the utility and usability of the tool for both patients and providers. Results: Implementation of the EHR-integrated electronic New Patient Intake Questionnaire improved collection of the PRD by increasing questionnaire accessibility for patients, while also providing all available data to clinicians and researchers. Careful consideration of the content and configuration of the questionnaire allowed for a successful, institute-wide implementation of the tool. Discussion: This effort demonstrates the feasibility of implementation of a system-wide electronic questionnaire, emphasizing the importance of iterative refinement to create a tool that is both patient-centric and usable for clinicians. Conclusions: The electronic New Patient Intake Questionnaire allows for systematic collection of the PRD, which should benefit cancer care outcomes through innovative care delivery and healthcare interventions. Lay Summary: The New Patient Intake Questionnaire at the Dana-Farber Cancer Institute has been in existence since 1989. In 2015 the Institute transitioned the intake questionnaire from paper to electronic and integrated it into the electronic health record. This manuscript describes the process, from start to finish, of developing the electronic intake questionnaire. Many stakeholders were involved in this process, including patients, clinical staff, and providers. The electronic intake questionnaire went through several updates in response to stakeholder feedback before reaching its final state. These updates in response to stakeholder feedback were the most important steps in creating an electronic questionnaire that is useful for both patients and providers.