Taking a Proactive Approach to Symptom Management

Stephanie GingerPatient Relationship Management, Patient Reported Outcomes

Advisory Board recently hosted a webinar that reviewed models and technologies that cancer programs have implemented for remote symptom monitoring. The Oncology Roundtable team shared their research and made a compelling business case for introducing remote symptom monitoring in cancer care. 

The Importance Symptom Management

Unnecessary emergency room (ER) visits and hospitalizations are on ongoing challenge. Advisory Board’s data group found that more than 50% of Medicare patients receiving chemotherapy visit the ER each year and 63% of those result in a hospitalization. That not only drives up costs, but also negatively impacts the patient experience. 

Cancer patients have several compelling reasons to avoid ERs – their immune systems are vulnerable and ER physicians may lack oncology-specific experience or provide inappropriate treatment. 

Patients are interested in access to specialized symptom management – they repeatedly list it as a top priority in Advisory Board Oncology Roundtable surveys. In addition, payers are placing new emphasis on symptom management. CMS recently announced it will track urgent care and hospitalizations in its Outpatient Quality Reporting program with measure OP-35, the first oncology-specific measure in the program.

The Advantages of Remote Monitoring

So why is remote symptom monitoring important? In one study, Advisory Board found that patients only report 10% of their symptoms to their care team. They may not know what they should report or who to call and they don’t want to bother their care team. This is where remote monitoring can make a big impact. Programs like Navigating Cancer’s Health Tracker prompt patients to report how they’re feeling – even if they are not currently dealing with any side effects. That removes those barriers mentioned above. Patient-reported outcomes (PROs) can then be monitored by the care team. With Health Tracker, serious symptom-related PROs are automatically added to the triage workboard, streamlining the workflow for the care team and enabling swift intervention by a nurse. 

Proactive Intervention for Symptom Management

If it seems overwhelming or unrealistic to monitor every patient in this way, Advisory Board recommends targeting the patients who will benefit the most – eg, patients with comorbidities, patients who are undergoing a particularly toxic treatment, patients experiencing a high level of distress, and patients who lack of support and other factors. 

They also recommended reserving time for same-day appointments. Even if the care team is aware of a patient’s issue and has a dedicated nurse to manage patients with urgent symptoms, without room in the schedule for same-day appointments patients may still end up in the ER.

The Advisory Board shared impressive results they have seen in their research. One organization estimated that without the availability of same-day appointments 45% of patients would have gone to the ER, and over 20% would have ultimately been hospitalized.

Another organization had a dedicated resource and standardized criteria for symptom evaluation, scheduling processes, protocols of care, and patient education materials. That resource was able to see 65% of patients experiencing serious symptoms the same day they called and saw a 35% decrease in ED visits per month on average. 

We are seeing similar reduction of resource use and costs for many of our partner practices. A study published in the Journal of Oncology Practice quantified the savings of two mid-sized community cancer providers that utilize Navigating Cancer’s Patient Relationship Management (PRM) solution for standardized telephone triage with integrated symptom management pathways. The study period spanned six months where the authors identified a 6% to 7% reduction in ER events due to symptom management using standardized pathways. They estimated that the annual number of avoided ER events due to triage was 426. That amounts to a savings of $3.85 million for the two practices. 

If you are looking to take a more proactive approach to symptom management with remote monitoring or would like a copy of the Advisory Board’s presentation, contact us today.