Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center. Issue 12 (14th December 2022)

• Record Type: Journal Article
• Authors: Cherny, Nathan I.; Parrinello, Christina M.; Kwiatkowsky, Lavi; Hunnicutt, Jeff; Beck, Thaddeus; Schaefer, Eric; Thurow, Tracy; Kolodziej, Michael
• Is Part Of: JCO oncology practice. Volume 18:Issue 12(2022)
• Page Start: e1918
• Page End: e1926
• Publication Date: 2022-12-14
• Subjects: Oncology -- Periodicals; Medical Oncology; Neoplasms; Oncology; Periodicals; 616.994
• DOI: 10.1200/OP.22.00180
• Languages: English
• ISSNs: 2688-1527

Abstract

Abstract : PURPOSE: The use of digital symptom monitoring with patient-reported outcomes (PROs) has been shown to improve patient outcomes. The evidence of benefit has been largely derived from research studies. The feasibility of adopting this technology in the real-world setting is unknown. METHODS: We report on the clinical implementation of a proprietary electronic patient-reported outcome (ePRO)–based digital symptom monitoring platform at the Highlands Oncology Group practice, a large community oncology practice. We present here our experience with patient enrollment, engagement, and retention; reasons for discontinued use; proportion of reports generating alerts and containing severe symptoms; and the responses to alerts including nursing telephone consultations and urgent office visits. RESULTS: Over an approximately 17-month period, 923 patients were successfully enrolled. Patients enrolled from June 20, 2020, through November 30, 2021, with follow-up through February 28, 2022. Retention rates at 3, 6, 9, and 12 months were 94%, 88%, 73%, and 67%, respectively, with greater retention at 12 months in patients age 65 years or older. Few patients discontinued use for reasons related to the platform (n = 47; 5%). Of the 25, 311 ePRO reports submitted, 49% (n = 12, 334) exceeded the predefined alert thresholds and 8% (n = 1, 920) included severe symptoms. The nursing team responded within 24 hours by telephone to 31.2% (n = 3, 910) of all reports with alerts. Of reports with severe symptoms, 72.7% (n = 1, 395) received a call. Only 6.4% (n = 249) of phone calls required an office evaluation within 72 hours of the report. CONCLUSION: This single-center experience indicates that an ePRO-based digital symptom monitoring platform can be effectively implemented at a large scale with a high level of long-term patient engagement. Most reports could be effectively resolved by nurses, and physician intervention was infrequently required.