Epstein Andrew S, Knezevic Andrea, Hoque Afshana, Rosa William E, Harding James J, Raj Nitya, Reidy Diane, Iyer Gopakumar V, Applebaum Allison J, Nelson Judith E
Memorial Sloan Kettering Cancer Center, New York, NY.
Weill Cornell Medical College, New York, NY.
JCO Oncol Pract. 2025 Jun 5:OP2500059. doi: 10.1200/OP-25-00059.
Patient portals increase communication, but little is known about response rates or patient characteristics associated with patient responses to portal-enabled questionnaires about health-related values (HRVs).
We tested feasibility of sending seven HRV questions by portal to medical oncology patients, with responses automatically returned to clinicians. HRV questionnaires were sent 1 week in advance of scheduled follow-up visits. The primary feasibility measure was patient response rate. Secondarily, we assessed patient characteristics associated with responses, and oncology clinicians' impressions.
One thousand five hundred fifty-six HRV questionnaires were sent by portal to as many individual patients of five total clinics between July 2023 and July 2024. Seven hundred thirty questionnaires were returned with at least one of the questions answered (47% response rate). Response rate increased significantly (45%-50%, = .05) after April 2024 when the portal notification was updated with a personalized message from oncologists and two study clinics were added to the initial 3. Nonresponders either returned a blank questionnaire (133, 9%) or did not return anything (693, 45%). Response rates were significantly different by patient race ( = .05): Asian (51%) and White (48%) versus Black (44%) and Hispanic (41%). Female patient responses were longer than males. Response time was associated with patients' oncology team and shorter after April 2024. Participating clinicians' impressions were consistently favorable.
Automating a patient portal-driven process to broadly scale elicitation of medical oncology outpatients' HRVs and sending aggregated reports of HRVs to oncology teams are feasible and valued by clinicians. Patient characteristics appear to be associated with responses. Ongoing research will investigate technology-supported strategies to optimize response rates across diverse populations (including minoritized patients who may suffer digital health inequity), and measure effects on person-centered communication and care outcomes.
患者门户网站可加强沟通，但对于患者对基于门户网站的健康相关价值观（HRV）问卷的回复率或与之相关的患者特征，我们了解甚少。
我们测试了通过门户网站向肿瘤内科患者发送七个HRV问题的可行性，回复会自动返回给临床医生。HRV问卷在预定的随访就诊前1周发送。主要的可行性指标是患者回复率。其次，我们评估了与回复相关的患者特征以及肿瘤内科临床医生的看法。
2023年7月至2024年7月期间，通过门户网站向五家诊所的1556名患者发送了HRV问卷。730份问卷至少有一个问题得到回答（回复率为47%）。2024年4月之后，当门户网站通知更新为肿瘤学家的个性化信息，且最初的3家诊所又增加了2家研究诊所时，回复率显著提高（从45%提高到50%，P = 0.05）。未回复者要么返回了空白问卷（133份，占9%），要么什么都没返回（693份，占45%）。不同种族患者的回复率存在显著差异（P = 0.05）：亚洲患者（51%）和白人患者（48%）高于黑人患者（44%）和西班牙裔患者（41%）。女性患者的回复比男性更长。回复时间与患者所在的肿瘤治疗团队有关，2024年4月之后回复时间更短。参与的临床医生的看法一直是积极的。
自动化患者门户网站驱动的流程，以广泛收集肿瘤内科门诊患者的HRV并将HRV汇总报告发送给肿瘤治疗团队是可行的，并且受到临床医生的重视。患者特征似乎与回复有关。正在进行的研究将调查技术支持的策略，以优化不同人群（包括可能遭受数字健康不平等的少数族裔患者）的回复率，并衡量对以患者为中心的沟通和护理结果的影响。
