Strachna Olga, Cohen Marc A, Allison Monica M, Pfister David G, Lee Nancy Y, Wong Richard J, McBride Sean M, Mohammed Raia R, Kemeny Elizabeth, Polubriaginof Fernanda C G, Kassa Alyse, Hannon Michael, Cracchiolo Jennifer R
Division of Health Informatics, Memorial Sloan Kettering Cancer Center, New York, New York.
School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey.
Cancer. 2021 Feb 1;127(3):359-371. doi: 10.1002/cncr.33272. Epub 2020 Oct 27.
Patient-reported outcomes (PROs) allow for the direct measurement of functional and psychosocial effects related to treatment. However, technological barriers, survey fatigue, and clinician adoption have hindered the meaningful integration of PROs into clinical care. The objective of the authors was to develop an electronic PROs (ePROs) program that meets a range of clinical needs across a head and neck multidisciplinary disease management team.
The authors developed the ePROs module using literature review and stakeholder input in collaboration with health informatics. They designed an ePROs platform that was integrated as the standard of care for personalized survey delivery by diagnosis across the disease management team. Tableau software was used to create dashboards for data visualization and monitoring at the clinical enterprise, disease subsite, and patient levels. All patients who were treated for head and neck cancer were eligible for ePROs assessment as part of the standard of care. A descriptive analysis of ePROs program implementation is presented herein.
The Head and Neck Service at Memorial Sloan Kettering Cancer Center has integrated ePROs into clinical care. Surveys are delivered via the patient portal at the time of diagnosis and longitudinally through care. From August 1, 2018, to February 1, 2020, a total of 4154 patients completed ePROs surveys. The average patient participation rate was 69%, with a median time for completion of 5 minutes.
Integration of the head and neck ePROs program as part of clinical care is feasible and could be used to assess value and counsel patients in the future. Continued qualitative assessments of stakeholders and workflow will refine content and enhance the health informatics platform.
Patients with head and neck cancer experience significant changes in their quality of life after treatment. Measuring and integrating patient-reported outcomes as a part of clinical care have been challenging given the multimodal treatment options, vast subsites, and unique domains affected. The authors present a case study of the successful integration of electronic patient-reported outcomes into a high-volume head and neck cancer practice.
患者报告结局（PROs）能够直接衡量与治疗相关的功能和心理社会影响。然而，技术障碍、调查疲劳以及临床医生的接受度阻碍了将PROs有意义地整合到临床护理中。作者的目标是开发一个电子PROs（ePROs）项目，以满足头颈多学科疾病管理团队的一系列临床需求。
作者通过文献综述和利益相关者的意见，并与健康信息学合作，开发了ePROs模块。他们设计了一个ePROs平台，该平台被整合为疾病管理团队中按诊断进行个性化调查交付的护理标准。Tableau软件用于创建仪表板，以便在临床机构、疾病亚部位和患者层面进行数据可视化和监测。所有接受头颈癌治疗的患者都有资格接受ePROs评估，作为护理标准的一部分。本文介绍了ePROs项目实施的描述性分析。
纪念斯隆凯特琳癌症中心的头颈科已将ePROs整合到临床护理中。调查在诊断时通过患者门户网站进行，并在整个护理过程中纵向开展。从2018年8月1日至2020年2月1日，共有4154名患者完成了ePROs调查。患者的平均参与率为69%，完成调查的中位时间为5分钟。
将头颈ePROs项目作为临床护理的一部分进行整合是可行的，并且未来可用于评估价值并为患者提供咨询。对利益相关者和工作流程持续进行定性评估将完善内容并增强健康信息学平台。
头颈癌患者在治疗后生活质量会发生显著变化。鉴于多模式治疗选择、众多亚部位以及受影响的独特领域，将患者报告结局作为临床护理的一部分进行测量和整合一直具有挑战性。作者展示了一个将电子患者报告结局成功整合到大量头颈癌诊疗实践中的案例研究。
