On June 4, 2021 Physicians from Dallas-based Texas Oncology and researchers from Seattle-based Navigating Cancer will present two posters highlighting the benefits of electronic patient management at the virtual 2021 ASCO (Free ASCO Whitepaper) Annual Meeting, which takes place June 4-8, 2021 (Press release, Navigating Cancer, JUN 4, 2021, View Source [SID1234583585]). The two poster presentations examine the impact that Navigating Cancer’s digital monitoring program, Health Tracker, has on symptom management for cancer patients at a large, multi-site community oncology practice.
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The first poster session titled, "Implementation of Electronic Patient-Reported Outcomes (ePROs) for Symptom Monitoring in a Large Multi-Site Community Oncology Practice," is part one of the Texas Two-Step study, a two-part (hybrid) implementation-effectiveness evaluation of ePROs. In part one of the Texas Two-Step study, researchers found that utilization of the ePRO tool can help provide just-in-time symptom management and, despite the challenges of the global COVID-19 pandemic on cancer practices, implementation of ePROs for digital symptom monitoring across a large multi-site statewide cancer practice is feasible, and compliance is high. Step two of the Texas Two-Step study will evaluate the impact ePROs have on healthcare resource utilization, time on therapy, and symptom control.
"The data shows that digital healthcare systems like Health Tracker can help clinicians manage their patients’ symptoms quickly and efficiently, potentially leading to improved clinical outcomes, fewer visits to emergency departments, higher patient satisfaction, and compliance with therapy," said lead author Debra Patt, M.D., Ph.D., MBA, medical oncologist and executive vice president, public policy, and strategic initiatives at Texas Oncology. "For cancer patients especially, response time is critical, and this technology allows care teams to monitor a patient’s symptoms in real-time and swiftly respond to patients who are in need and require symptom control. It also gives us better insight on compliance with oral therapies."
The second poster session titled, "Improvement in Incident Resolution Time with the Implementation of an Electronic Patient Management Solution at a Community Oncology Practice," evaluates the impact of the digital monitoring program on time to symptom resolution – prolonged times to system resolution can lead to unnecessary emergency department visits. The researchers found that the program, with Plan Do Study Act (PDSA) cycles of quality improvement, can markedly improve incident resolution times, especially for symptom-related calls.
"Staying connected with cancer patients and monitoring their symptoms outside of the clinic can be challenging for busy clinicians," said Bill Bunker, CEO of Navigating Cancer. "This research demonstrates that when technology is effectively integrated into existing practice workflows, it can fill this care gap and drive improved outcomes and better experiences for patients."
Texas Oncology focuses on delivering quality cancer care and mitigating healthcare disparities for Texans fighting cancer through its locations in communities of all sizes throughout the state, including smaller cities and towns. In addition, telemedicine connects patients with care teams both locally and with access to specialized physician expertise in other cities. Online support groups, including nutrition support groups, serve patients no matter where they live so they can receive the critical support they need.
The full abstracts and both posters are available at NavigatingCancer.com/publications. Additional insights into the Texas Two-Step study are available in the JCO Clinical Cancer Informatics.
Abstract Summaries:
Implementation of Electronic Patient-Reported Outcomes for Symptom Monitoring in a Large Multi-Site Community Oncology Practice, Abstract 12103
Lead author: Debra Patt M.D., Ph.D., MBA, medical oncologist and executive vice president, public policy, and strategic initiatives at Texas Oncology
Patients initiating a new systemic therapy at one of 210 Texas Oncology practice sites were invited to use the Navigating Cancer ePRO platform from July-December 2020. Participating patients received a weekly prompt by SMS text message or email (patient choice) to self-report common symptoms and well-being via computer or smartphone. Severe self-reported symptoms triggered a real-time notification alert to a triage nurse to address the symptom.
Highlights:
More than 4,000 cancer patients initiating systemic therapy enrolled in the program throughout the study period with 25% of patients living more than 20 miles from their clinic.
Of the patients who were enrolled in the platform, 73% completed at least one ePRO assessment, and among these individuals, 65% of all available weekly ePRO assessments were completed.
SMS (89%) was strongly preferred over email (6%) or clinic collect (5%). SMS was also associated with the highest participation rate (77%) vs. email (54%) or clinic collect (45%).
Improvement in Incident Resolution Time with the Implementation of an Electronic Patient Management Solution at a Community Oncology Practice, Abstract 1578
Lead author: Lalan Wilfong, M.D., medical oncologist and executive vice president for value-based care and quality programs at Texas Oncology
Incident volumes and resolution times were monitored at all Texas Oncology locations along with the implementation of PDSA cycles, which had a goal of less than 90-minute resolution of symptom-related incidents. Utilizing Navigating Cancer’s electronic dashboard allowed Texas Oncology to continue this initiative during the pandemic as some staff could work remotely. Nurses could document if a potential emergency department visit was avoided, and these data points allowed the practice to establish comprehensive and strategic actions plans for quality improvement.
Highlights:
Resolution time for all incidents started at 3.2 hours pre-implementation and improved to 2.2 hours in December 2020.
Sixty-two percent of symptom-related incidents were resolved in less than one hour.
Eight percent of symptom-related incidents resulted in definite or probable emergency department avoidances by nursing assessment.
Shortness of breath, vomiting, chills, and weakness were the top symptom types addressed for emergency department avoidances.