Integrating Patient-Reported Outcomes in Cancer Care

Stephanie GingerPatient Reported Outcomes, Remote Monitoring, Symptom Management

If you’ve been paying attention to trends in the discussions around value-based cancer care, you’ve probably been hearing a good bit about electronic patient-reported outcomes (ePROs). At the National Oncology Conference, Dr. Ethan Basch, a leading patient-reported outcomes researcher, was the recipient of ACCC’s Clinical Research Award for his remarkable findings in that field. CMMI’s proposed successor to the Oncology Care Model includes the gradual introduction of ePROs into the model. And there was a recent panel at AJMC’s Patient-Centered Oncology Care Conference focused on this topic.

The panel explored the challenges and potential of integrating the patient’s voice into the care model.

Making an ePRO Program Work

Electronic-based tools have to work for both patients and providers. If the value isn’t clear or the effort too steep, it will be difficult to get widespread adoption. New tools must reduce the burden for providers, improve the patient experience, and be seamlessly integrated into clinical workflows and everyday lives of patients.

ePROs were described as an important element for integrating the broader patient voice into cancer care. When ePROs are combined with ongoing patient management, shared-decision making, and supporting physician workflow, they can be very meaningful.

This type of technology also needs to accommodate different socioeconomic backgrounds, different languages, rural locations with limited infrastructure, and other factors.

Ensuring the Value of ePROs

There are two important customers to be considered for this tool: patients and providers. Patients must see a clear benefit in participating and the information needs to be actionable for an empowered care team.

Some of the benefits that panelists can see:

  • Giving patients a tool to provide information that helps the care team ward off problems before they develop in the first place will save time – similar to the way nursing assessments save physicians time.
  • While there may be a short term work burden, knowing about a symptom earlier is a lot easier to manage than, for instance, treating sepsis in a hospital.

On the topic of saving money, there wasn’t a clear answer – however, if one unnecessary ER visit can be prevented each month, an ePRO program could pay for itself.

With other changes in care that have been made to meet the requirements of value-based care, one panelist noted he saw clear benefits like reduced hospitalizations and happier patients, but he also noted that it wasn’t easy. Changing an existing process takes transformation whether it’s replacing a phone tree or adding after hours support. He also shared that his triage system isn’t perfect and patients are still sometimes ending up in the ER when it could have been avoided. While it will take work, incorporating ePROs would fill a gap in care for patients and care teams.

Next steps

If you want to learn more about implementing an ePRO program in your practice, Navigating Cancer’s ePRO tool, Health Tracker, may be a great place to start. This lightweight solution can be used for patients with a smartphone, an email account, or simply a telephone.

Health Tracker addresses many of the challenges that providers have identified:

  • It auto-populates patient responses into a workboard that is stratified by risk – more severe symptoms reported move to the top of the list and a triage ticket is created so the team is empowered to take action.
  • It includes a “clinic collect” option so if the patient only has access to a telephone, a member of the care team can enter responses on their behalf.
  • It’s flexible – you can check-in with patients about symptoms, oral adherence, or both, according to a schedule you and your patient choose together.

Interested in learning more? Contact us today.