Adoption patterns of an electronic patient-reported outcomes tool in oncology.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19127-e19127
Author(s):  
Fernanda CG Polubriaginof ◽  
Priti K Parekh ◽  
Naga Ravi Shankar Akella ◽  
Peter D. Stetson
Keyword(s):  
Patient Reported Outcomes ◽  
Standard Of Care ◽  
Completion Rate ◽  
Completion Rates ◽  
Demographic Information ◽  
Patient Demographic ◽  
Patient Reported ◽  
Usage Patterns ◽  
Survey Instruments ◽  
Patient Demographic Information

e19127 Background: Patient-reported outcomes (PROs) are critical for the delivery of patient-centric care. Previous research has shown that the use of PROs can impact clinical outcomes in Oncology. Despite these benefits, PROs have not been widely implemented as part of standard of care. Significant barriers exist for its adoption including lack of integration between PRO tools and electronic health record systems (EHRs). We developed MSK Engage, a home-grown PRO tool integrated with the EHR and embedded within MSK's patient portal (MyMSK). It was launched in late 2015 and it is currently used enterprise-wide for both standard of care and research purposes. The purpose of this study was to describe the usage patterns of PROs in a real-world setting. Methods: We conducted a retrospective analysis of patients that have been assigned at least one MSK Engage survey instrument between 2015 and 2019. Patient demographic information was extracted from the EHR system. Usage patterns including the number of survey instruments assigned and completed were extracted from MSK Engage. Survey completion rates were stratified by patient demographic information and number of assigned surveys. We performed univariate and multivariate analyses to identify factors associated with survey completion rates. Results: During the study period, 57 survey instruments were implemented, with the majority being used for standard of care (41 for standard of care only, 9 for research protocols, 6 for standard of care and research, and one for a quality improvement initiative). In total, 246,638 patients were assigned 557,559 surveys. Of those, 146,505 patients completed a total of 265,174 surveys, with a median completion time of 3 minutes. Among the patients that were assigned a survey, 73.7% were women. Women in our sample were older than men, with median age 52 and 47 years old, respectively. Men were more likely to complete the assigned surveys with 61.2% completion rate among men and 43.3% among women (p < 0.001). On multivariate analysis, men were less likely to miss surveys than women (odds ratio [OR], 0.49; 95% CI, 0.48-0.49). We also identified a significant correlation between the survey completion rate and number of assigned surveys, demonstrating that assigning a large number of surveys for each patient can lead to a reduced survey response. Conclusions: Providers have quickly adopted MSK Engage demonstrating that it is feasible to incorporate PROs as part of standard of care. Patients are willing to answer PROs; however, it is important to mindful when assigning surveys to avoid negative effects of survey burden.

scholarly journals Home-Based Assessment of Patient Reported Outcome Measures Using a Smartphone App Platform: A Feasibility Study

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 420-420
Author(s):  
Sherif M. Badawy ◽  
Leonardo Barrera ◽  
Graham Zolkowski ◽  
Zeinab Alward
Keyword(s):  
Sickle Cell ◽  
Patient Reported Outcomes ◽  
Computerized Adaptive Testing ◽  
Completion Rate ◽  
Completion Rates ◽  
Patient Reported ◽  
Group A ◽  
Hrqol Assessment ◽  
Group B ◽  
At Home

Background: Sickle cell disease (SCD) is the most common genetic disorder in the United States, affecting 100,000-120,000 Americans. SCD Complications include pain episodes, chronic anemia and long-term end organ damage. These complications result in significant declines in health-related quality of life (HRQOL) and other patient-reported outcomes (PROs) across the lifespan. However, PROs are not routinely monitored in the clinical setting or at home in SCD, and the ideal frequency of HRQOL assessment remains unclear. Additionally, prior studies suggested that frequent PRO assessments result in patient survey fatigue. Patient Reported Outcomes Measurement Information System (PROMIS®) is an NIH-endorsed, novel, reliable platform for the assessment of PROs, including physical, mental, and social aspects of HRQOL. PROMIS® also utilizes a unique approach for patient- or parent proxy-report using Computerized Adaptive Testing (CAT) with a comprehensive, item-response theory optimized item bank. Specific Aims: (1) To evaluate the feasibility and acceptability of the assessment of patients HRQOL at home using smartphones with PROMIS®-CAT measures integrated into a SCD-app; (2) To examine the effect of the frequency of HRQOL assessments on participants' completion rate over 24-week period with HRQOL evaluated every 2 weeks (Group 1) vs. every 4 weeks (Group 2); and (3) To explore participants' experience and preferences with the process and the frequency of HRQOL assessment at home using their smartphones with PROMIS®-CAT measures integrated into a SCD-app as a user-centered approach. Hypotheses: The assessment of patients' HRQOL at home using a SCD smartphone application (app) platform is feasible and acceptable, and that less frequent assessments of HRQOL at home will have an overall higher completion rate when compared to more frequent ones. Methods: In this pilot randomized trial, patients and their parents were enrolled from comprehensive sickle cell clinic at Lurie Children's Hospital of Chicago. Patients were eligible if they were 12 years or older and had a SCD diagnosis. Loaner smartphones were provided to eligible participants who did not have access to a smartphone. Participants were randomly assigned to either Group A (every 2 weeks) or Group B (every 4 weeks) HRQOL assessment using PROMIS®-CAT measures using our SCD-app. PROMIS®-CAT measures included fatigue, pain intensity, depression, anxiety and peer relationships. At enrollment, participants had SCD-app downloaded and set-up on their smartphones and completed demographics and technology comfort questionnaire. At the end of the study, participants completed a semi-structured interview with an app usability evaluation as well as acceptability and satisfaction questionnaires. Results: A total of 42 patients participated (57% males, 91% Black, age [mean±SD] 15.7±3 years old) with 94% enrollment rate. Overall HRQOL assessment completion rate was 56.4% among all participants, meeting our feasibility criteria of ≥50%, including 65% for patients and 47.9% for parents (P=0.13). Completion rates were significantly higher in Group B [every 4 weeks] compared to Group A [every 2 weeks] among patients only (71.7% vs. 59.3, P=0.005) and all participants [patients/parents] (65.4% vs. 45.5%, P&lt;0.001), respectively. Similar findings were seen among parents with trend towards significance (Group B [58.3%] vs. Group A [37.5%], P=0.09). Participants who completed assessments using iPads had significantly higher completion rates compared to iPhones (100% vs. 45.2%, P&lt;0.001), respectively. Similar findings were seen among participants who installed SCD-app at home compared to those who did so in clinic (83.3% vs. 47%, P&lt;0.001), respectively. Acceptability, usability and satisfaction scores were high among participants (86-100%). Participants provided additional detailed feedback to improve the user interface for the next iteration of our SCD-app. Conclusions: The completion of HRQOL assessments at home using PROMIS®-CAT measures integrated into a SCD-app is feasible and acceptable. Completion rates were significantly higher with less frequent HRQOL assessment (every 4 weeks) and using iPads. Future longitudinal studies are needed to better understand how to present PRO scores to patients, use them to direct clinical decisions and how to integrate PRO assessments as part of routine care for patients with SCD. Disclosures No relevant conflicts of interest to declare.

Patient Adoption and Utilization of a Web-Based and Mobile-Based Portal for Collecting Outcomes After Elective Orthopedic Surgery

2018 ◽  
Vol 33 (6) ◽  
pp. 649-656 ◽  
Author(s):  
Kerri Bell ◽  
Eugene Warnick ◽  
Kristen Nicholson ◽  
Sarah Ulcoq ◽  
Seong Jin Kim ◽  
...  
Keyword(s):  
Health Care ◽  
Orthopedic Surgery ◽  
Patient Reported Outcomes ◽  
Elective Surgery ◽  
Mobile App ◽  
Data Capture ◽  
Completion Rates ◽  
Web Based ◽  
Online Portal ◽  
Patient Reported

Health care increasingly collects patient-reported outcomes (PROs) via web-based platforms. The purpose of this study was to evaluate how patient age influences portal engagement. Patients undergoing elective surgery at a single multispecialty orthopedic practice from September 2014 to February 2017 had access to an online portal to complete PROs, message the clinic, and view physical therapy instructions. A mobile app was optionally available. Age, sex, log-in frequency, PRO completion rates, and number of messages sent were reviewed retrospectively. Message frequency, log-in rates, and PRO compliance were highest for patients aged 41 to 50, 51 to 60, and 61 to 70, respectively. Mobile app use decreased with age ( P = .002); yet, at all ages, the mobile app group was more engaged. In particular, for patients aged 18 to 30 years, log-in frequency increased 2.5-fold and PRO compliance improved 44% ( P < .001) in the mobile app group. This study demonstrates that portal interaction varies by age and that data capture is highest in patients who choose the mobile app.

Electronic Patient-Reported Outcomes: A New Standard of Care?

Oncology ◽  
2018 ◽  
Vol 98 (Suppl. 6) ◽  
pp. 327-328
Author(s):  
Paul Martin Putora
Keyword(s):  
Patient Reported Outcomes ◽  
Standard Of Care ◽  
Patient Reported

Characterizing patient-reported outcomes as standard of care

2020 ◽  
Vol 159 ◽  
pp. 271
Author(s):  
S.H. Theodos ◽  
J.M. James ◽  
T.M. Beasley ◽  
A. Gilbert ◽  
J.Y. Pierce ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Standard Of Care ◽  
Patient Reported

Pilot study of iPad-based patient-reported outcomes at the MGH Cancer Center.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 190-190
Author(s):  
Aparna Raj Parikh ◽  
Margaret Soriano ◽  
Ephraim P. Hochberg ◽  
Courtney McLeish ◽  
Inga Tolin Lennes ◽  
...  
Keyword(s):  
Real Time ◽  
Cancer Patients ◽  
Patient Reported Outcomes ◽  
Cancer Center ◽  
Completion Rates ◽  
Breast Lymphoma ◽  
Patient Reported ◽  
Front Desk ◽  
Chemotherapy Patients ◽  
To Receive

190 Background: Patient reported outcomes (PROs) have been shown to improve outcomes in cancer patients in clinical trials and have also been shown to improve the patient experience, provide real-time access to patient reported symptoms and are increasingly used across disciplines. Given the importance of PROs, at the MGH Cancer Center, we implemented a pilot using iPADs to capture patient reported outcomes for patients receiving IV chemotherapy in the breast and lymphoma clinics as well all IV chemotherapy patients at one of the MGH satellite clinics where patients across all disease groups are seen. Methods: 12 measures from the PRO-CTCAE were selected to be applicable to all cancer patients. Working with the technology team and EPIC team at MGH the selected PROs were loaded into iPADs and are automatically assigned to patients receiving IV chemotherapy. Staff and clinicians were trained in the breast, lymphoma and satellite clinic. Patient who were receiving IV chemotherapy were assigned iPADs at check in. Patients completed the questionnaire and in real-time, the data was available in the EPIC chart. The objectives of the pilot were to assess the feasibility of collecting iPAD based PROs at the MGH Cancer Center. Results: In the 4-month pilot, there were 2,304 visit types that were eligible to receive an iPAD for PRO collection, 79% (N = 1,1816) patients were assigned an iPAD. Of the 1,816 patients assigned an iPAD, 65% (N = 1,173) patients completed the PROs, 4% (N = 36) partially completed the PROs. In terms of completion at the main disease specialty clinic vs the satellite, completion rates were higher at the satellite (77% vs 44%). During one week, we asked the front desk to record why patients did not complete the PROs-93 patients were assessed, 45% of patient refused the iPAD, in 28% of these patients the staff did not capture the reason and 22% were not given an iPAD. Conclusions: This pilot demonstrates the feasibility of collecting PROs in an oncology clinic for patients receiving IV chemotherapy. We plan to continue to improve the assignment of PROs to eligible patients, educate staff, providers and patients on the important of PROs and plan to expand to all the clinics at MGH Cancer Center and satellite centers.

scholarly journals Significant Differences Exist in Patient Demographics of Foot and Ankle Surgeries between High Quality Prospective Studies and National Databases

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Zilan Lin ◽  
Ray Boaz ◽  
Christopher Gross
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Calcaneal Fracture ◽  
Study Data ◽  
Foot And Ankle ◽  
Syndesmotic Injury ◽  
Demographic Information ◽  
Lisfranc Injury ◽  
Patient Demographic ◽  
Patient Demographic Information

Category: Trauma Introduction/Purpose: Several high profile studies have compared surgical and non-operative treatments in specific types of major foot and ankle surgeries and serve as management guidelines for many Orthopaedic surgeons. However, the external validity of these studies has not been examined and should be confirmed in order to confidently apply the study conclusions to the national population and modify clinical practice. The purpose of the current study was to compare patient demographic information collected from major high quality, prospective studies in foot and ankle surgeries and from same surgical procedures recorded in a nationwide database of the United States patient population. Methods: Patient demographic information from surgical procedures for achilles tendon rupture, syndesmotic injury, calcaneal fracture, and lisfranc injury were pulled from American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database between 2005 – 2014 by using CPT codes listed in Table I. The same information was collected from several randomized control or prospective cohort studies identified for each type of procedure (Table I). Patient age and body mass index (BMI) were compared by using two sample T-test, while Fisher’s exact test was used to compare patient sex. Study data on age and BMI that did not provide both mean and standard deviation were not included in analysis. Results: In the NSQIP database, 1,633 achilles tendon repair and 8,852 syndesmotic injury cases were identified, but few calcaneal fracture surgeries and no lisfranc injury cases were found. For surgical cases with syndesmotic injury repair, age, sex and BMI all differed significantly between NSQIP data and the aggregate values of published studies, with the NSQIP patients being older and have more females and larger BMI (Tables II-IV). By comparing individual study data with NSQIP, 1 of 3 studies showed the same trend in age, 2 of 3 in sex, and 1 of 1 in BMI. For cases with Achilles tendon rupture repair, both aggregate and individual comparisons with 2 studies showed statistical difference on age, with NSQIP patients being older (Table II). Conclusion: Although the results were somewhat mixed, statistical significance did exist in patient demographic characteristics between published clinical data and a national database in the same foot and ankle surgeries. Caution should be warranted when interpreting clinical studies and before generalizing it onto the national population.

Analysis of Satisfaction of Patients Undergoing Breast Augmentation Using BREAST-Q

2020 ◽  
pp. 074880682092983
Author(s):  
Muhammad Ahmad
Keyword(s):  
Patient Satisfaction ◽  
General Anesthesia ◽  
Breast Augmentation ◽  
Cosmetic Surgery ◽  
Patient Reported Outcomes ◽  
Fat Transfer ◽  
Significant Difference ◽  
Patient Reported ◽  
Survey Instruments ◽  
The Mean

The objective of this study was to document a patient’s evaluation after breast augmentation using BREAST-Q. The study was conducted in a private cosmetic surgery setup among female patients undergoing breast augmentation silicone implant surgery or fat transfer. All the surgeries were performed by a single surgeon under general anesthesia. Three parameters of BREAST-Q were noted preoperatively and after 9months. All the data were analyzed statistically. The mean age of the patients was 28.6 years. The average implant volume was 331 mL (range, 250-455 mL). The patients undergoing fat transfer had an average of 391.7 mL (range, 295-450 mL) injected on each side. There was a statistically significant difference noted in the scores preoperatively and postoperatively. The use of validated survey instruments plays an important role in improving patient-reported outcomes. Breast augmentation with fat transfer was shown to have higher patient satisfaction using BREAST-Q.

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