Cargando…

Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Cherny, Nathan I., Parrinello, Christina M., Kwiatkowsky, Lavi, Hunnicutt, Jeff, Beck, Thaddeus, Schaefer, Eric, Thurow, Tracy, Kolodziej, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9750604/
https://www.ncbi.nlm.nih.gov/pubmed/36240475
http://dx.doi.org/10.1200/OP.22.00180
_version_ 1784850291979452416
author Cherny, Nathan I.
Parrinello, Christina M.
Kwiatkowsky, Lavi
Hunnicutt, Jeff
Beck, Thaddeus
Schaefer, Eric
Thurow, Tracy
Kolodziej, Michael
author_facet Cherny, Nathan I.
Parrinello, Christina M.
Kwiatkowsky, Lavi
Hunnicutt, Jeff
Beck, Thaddeus
Schaefer, Eric
Thurow, Tracy
Kolodziej, Michael
author_sort Cherny, Nathan I.
collection PubMed
description 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.
format Online
Article
Text
id pubmed-9750604
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-97506042022-12-15 Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center Cherny, Nathan I. Parrinello, Christina M. Kwiatkowsky, Lavi Hunnicutt, Jeff Beck, Thaddeus Schaefer, Eric Thurow, Tracy Kolodziej, Michael JCO Oncol Pract ORIGINAL CONTRIBUTIONS 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. Wolters Kluwer Health 2022-12 2022-10-14 /pmc/articles/PMC9750604/ /pubmed/36240475 http://dx.doi.org/10.1200/OP.22.00180 Text en © 2022 by American Society of Clinical Oncology https://creativecommons.org/licenses/by-nc-nd/4.0/Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle ORIGINAL CONTRIBUTIONS
Cherny, Nathan I.
Parrinello, Christina M.
Kwiatkowsky, Lavi
Hunnicutt, Jeff
Beck, Thaddeus
Schaefer, Eric
Thurow, Tracy
Kolodziej, Michael
Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center
title Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center
title_full Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center
title_fullStr Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center
title_full_unstemmed Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center
title_short Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center
title_sort feasibility of large-scale implementation of an electronic patient-reported outcome remote monitoring system for patients on active treatment at a community cancer center
topic ORIGINAL CONTRIBUTIONS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9750604/
https://www.ncbi.nlm.nih.gov/pubmed/36240475
http://dx.doi.org/10.1200/OP.22.00180
work_keys_str_mv AT chernynathani feasibilityoflargescaleimplementationofanelectronicpatientreportedoutcomeremotemonitoringsystemforpatientsonactivetreatmentatacommunitycancercenter
AT parrinellochristinam feasibilityoflargescaleimplementationofanelectronicpatientreportedoutcomeremotemonitoringsystemforpatientsonactivetreatmentatacommunitycancercenter
AT kwiatkowskylavi feasibilityoflargescaleimplementationofanelectronicpatientreportedoutcomeremotemonitoringsystemforpatientsonactivetreatmentatacommunitycancercenter
AT hunnicuttjeff feasibilityoflargescaleimplementationofanelectronicpatientreportedoutcomeremotemonitoringsystemforpatientsonactivetreatmentatacommunitycancercenter
AT beckthaddeus feasibilityoflargescaleimplementationofanelectronicpatientreportedoutcomeremotemonitoringsystemforpatientsonactivetreatmentatacommunitycancercenter
AT schaefereric feasibilityoflargescaleimplementationofanelectronicpatientreportedoutcomeremotemonitoringsystemforpatientsonactivetreatmentatacommunitycancercenter
AT thurowtracy feasibilityoflargescaleimplementationofanelectronicpatientreportedoutcomeremotemonitoringsystemforpatientsonactivetreatmentatacommunitycancercenter
AT kolodziejmichael feasibilityoflargescaleimplementationofanelectronicpatientreportedoutcomeremotemonitoringsystemforpatientsonactivetreatmentatacommunitycancercenter