PROMs Efficacy: Variation Between Institutions
- CHICAGO — A recent study presented at the ASCO Annual Meeting revealed that using an electronic, EHR-integrated symptom management program to collect patient-reported outcomes did not significantly decrease...
- Notably, only about half of the patients actively used the system to report their symptoms.
- Hassett, chief quality officer at dana-Farber Cancer Institute, noted the unexpected variations across different institutions."We saw two institutions that demonstrated a benefit with the intervention,two where the effect...
This study reveals a mixed bag for patient-reported outcomes programs (PROMs) in cancer care. While designed to reduce hospital visits, the electronic system showed no significant decrease in emergency department or inpatient admissions overall. However, this primary_keyword initiative demonstrated distinct variations, with some institutions reporting benefits, while others saw increased acute care utilization. The secondary_keyword of patient engagement, key to any program’s success, was also a factor, with only half of patients actively participating. News Directory 3 explores these findings, highlighting the need for tailored implementation strategies. Discover what’s next in optimizing PROMs for better patient outcomes by reviewing how various factors impact success.
Electronic Patient-Reported Outcomes Program Shows Mixed Results in Cancer Care
CHICAGO — A recent study presented at the ASCO Annual Meeting revealed that using an electronic, EHR-integrated symptom management program to collect patient-reported outcomes did not significantly decrease emergency department (ED) visits or inpatient admissions following cancer treatment. The study highlights the complexities of implementing such programs and the impact of patient engagement.
Notably, only about half of the patients actively used the system to report their symptoms. Researchers suggest that barriers to health care system implementation and patient engagement may have limited the program’s effectiveness in reducing hospital visits.
Michael J. Hassett, chief quality officer at dana-Farber Cancer Institute, noted the unexpected variations across different institutions.”We saw two institutions that demonstrated a benefit with the intervention,two where the effect was a higher rate of acute care utilization and two where it was stable,” Hassett said. “We just weren’t expecting to see such heterogeneity by site.”
Challenges in Implementation
While electronic patient-reported outcomes have shown promise in reducing resource use and improving patient outcomes, their implementation faces hurdles. These include poor patient engagement, staff limitations, and technical deployment issues.
The study, conducted between January 2018 and february 2023, involved nearly 40,000 adults undergoing chemotherapy or recovering from surgery for gastrointestinal, gynecologic, or thoracic cancer. Patients in the intervention arm used the eSyM system to report symptoms, receiving alerts, self-management tips, and communication support.
The researchers tracked ED visits and inpatient admissions within 30 and 90 days of treatment. The data revealed that the intervention did not significantly reduce these events overall. However, variations were observed when data was stratified by health system, suggesting that local factors play a crucial role in the success of such programs.
“It makes you wonder if maybe that the way surgeons deal with managing symptoms is just different,” Hassett said. “Surgeons aren’t in clinic all the time, so if we are identifying more symptoms and we are generating more calls, that may lead to more use of the emergency room as surgeons might potentially be less likely to send patients to clinic.”
Hassett added that structural issues, such as nursing availability and infusion center hours, significantly influence symptom management and can affect the impact of interventions designed to improve communication and symptom awareness.
What’s next
Further research is needed to understand the factors that contribute to the variability in outcomes across different health systems. Addressing patient engagement barriers and tailoring implementation strategies to specific institutional contexts may improve the effectiveness of electronic patient-reported outcome programs in reducing acute care utilization.