Eichler Martin, Hentschel Leopold, Hornemann Beate, Schuler Markus, Richter Stephan, Meier Friedegund, Weitz Jürgen, Schaser Klaus-Dieter, Krause Mechthild, Mütherig Anke, Thomas Tina, Weigmann-Faßbender Sandra, Schmädig Roman, Rentsch Anke, Vetter Heike, Kemmerer Matthias, Ehninger Gerhard, Eberlein-Gonska Maria, Schmitt Jochen, Bornhäuser Martin, Hofbauer Christine
Nationales Zentrum für Tumorerkrankungen (NCT/ UCC), Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.
Nationales Zentrum für Tumorerkrankungen (NCT/ UCC), Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2024 Dec;190-191:72-83. doi: 10.1016/j.zefq.2024.09.005. Epub 2024 Nov 16.
To what extent and under what conditions electronically captured patient-reported outcomes (ePROs) can be used in routine medical care and contribute to improved patient care is a widely discussed question. In the field of oncology, few studies in Germany have focused this topic that go beyond the scope of time-limited studies.
First, we present the centrally coordinated collection of ePROs in the routine care of a comprehensive cancer center of the German Cancer Aid in its development, and then describe its qualitative dimension. Subsequently, the intervention is discussed using the Consolidated Framework of Implementation Research.
Since the implementation started in 2019, over 2,000 patients from the interdisciplinary outpatient clinic of the oncology center have been surveyed. The number of respondents varied between 19 and 65 per month. Over the five years of the reporting period, numerous adjustments have been made regarding content and usage purposes as well as technical and personnel structures. The consistent purpose of use was screening for supportive needs, initially related to psycho-oncology, later expanded to include sports therapy, smoking cessation programs, social and nutritional counseling. The instruments used varied accordingly; health-related quality of life and psychological stress were consistently surveyed.
Successful use of ePROs in oncological routine care requires personnel and technical resources as well as a high degree of adaptability. In our case, the complexity of a centrally coordinated ePRO collection within an interdisciplinary cancer center is of particular importance. Path dependencies arising from initial decisions, such as the survey software, need to be considered during implementation. Reservations about the intervention and the importance of opinion leaders for successful deployment have been observed. External conditions such as the certification system of oncology centers in Germany proved to be another relevant factor.
Overall, the analysis examines a segment of the ongoing digitization process of the hospital system directed towards needs-based, individualized patient care.
电子采集的患者报告结局（ePROs）在何种程度以及何种条件下可用于常规医疗护理并有助于改善患者护理，这是一个广泛讨论的问题。在肿瘤学领域，德国很少有超出限时研究范围的研究关注这一主题。
首先，我们介绍德国癌症援助中心综合癌症中心在其发展过程中常规护理中ePROs的集中协调收集情况，然后描述其定性维度。随后，使用实施研究的综合框架对该干预措施进行讨论。
自2019年实施以来，肿瘤中心跨学科门诊的2000多名患者接受了调查。每月的受访者数量在19至65人之间。在报告期的五年中，在内容和使用目的以及技术和人员结构方面进行了多次调整。一致的使用目的是筛查支持性需求，最初与心理肿瘤学相关，后来扩大到包括运动疗法、戒烟计划、社会和营养咨询。所使用的工具也相应有所不同；始终对与健康相关的生活质量和心理压力进行调查。
在肿瘤学常规护理中成功使用ePROs需要人员和技术资源以及高度的适应性。在我们的案例中，跨学科癌症中心内集中协调的ePRO收集的复杂性尤为重要。在实施过程中需要考虑初始决策产生的路径依赖性，例如调查软件。已观察到对该干预措施的保留意见以及意见领袖对成功部署的重要性。事实证明，德国肿瘤中心的认证系统等外部条件是另一个相关因素。
总体而言，该分析考察了医院系统正在进行的数字化进程中以需求为导向、个性化患者护理的一个环节。
