scholarly journals Multilingual Conversational Systems to Drive the Collection of Patient-Reported Outcomes and Integration into Clinical Workflows

Symmetry ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1187
Author(s):  
Izidor Mlakar ◽  
Valentino Šafran ◽  
Daniel Hari ◽  
Matej Rojc ◽  
Gazihan Alankuş ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Patient Reported Outcomes ◽  
Patient Adherence ◽  
Conversational Agents ◽  
Clinical Workflow ◽  
Embodied Conversational Agent ◽  
Multimodal Sensing ◽  
Patient Reported ◽  
Patient Resources ◽  
Main Components

Patient-reported outcomes (PROs) and their use in the clinical workflow can improve cancer survivors’ outcomes and quality of life. However, there are several challenges regarding efficient collection of the patient-reported outcomes and their integration into the clinical workflow. Patient adherence and interoperability are recognized as main barriers. This work implements a cancer-related study which interconnects artificial intelligence (spoken language algorithms, conversational intelligence) and natural sciences (embodied conversational agents) to create an omni-comprehensive system enabling symmetric computer-mediated interaction. Its goal is to collect patient information and integrate it into clinical routine as digital patient resources (the Fast Healthcare Interoperability Resources). To further increase convenience and simplicity of the data collection, a multimodal sensing network is delivered. In this paper, we introduce the main components of the system, including the mHealth application, the Open Health Connect platform, and algorithms to deliver speech enabled 3D embodied conversational agent to interact with the cancer survivors in five different languages. The system integrates cancer patients’ reported information as patient gathered health data into their digital clinical record. The value and impact of the integration will be further evaluated in the clinical study.

scholarly journals Multilingual Conversational Systems to Drive the Collection of PROs and Integration into Clinical Workflow

2021 ◽  
Vol 18 ◽  
pp. 113-118
Author(s):  
Daniel Hari ◽  
Valentino Šafran ◽  
Umut Arioz ◽  
Izidor Mlakar ◽  
Matej Rojc ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Holistic Approach ◽  
Conversational Agents ◽  
Clinical Workflow ◽  
Horizon 2020 ◽  
Multimodal Sensing ◽  
Patient Reported ◽  
Preparation Phase ◽  
Spoken Interaction

Collection of patient-reported outcomes (PROs) remotely and their usage in the clinical workflow provide an improvement on both patient’s quality of life and cancer care. However, adoption of collecting PROs into the clinical workflow is rare, and existing works still have a lot of issues providing a holistic approach. This paper offers enhancements in the process of collecting PROs by utilization of conversational systems that still provide quite a new but promising way to collect PROs remotely with spoken interaction. Our proposed system provides an interoperability with Fast Healthcare Interoperability Resources (FHIR) server by using a multimodal sensing network (MSN) prepared for the project PERSIST. We introduce components of multimodality while collecting PROs with the help of the mHealth App and Open Health Connect (OHC) platform. As a result, chatbots and 3D embodied conversational agents (ECA) were prepared to interact with the cancer patients in 5 different languages. The intercommunication was provided by MSN and the integration of cancer patients’ PROs into clinical workflow was satisfied. This study was part of a Horizon 2020 project and a preparation phase for clinical trials with cancer patients and clinicians

scholarly journals The feasibility of web surveys for obtaining patient-reported outcomes from cancer survivors: a randomized experiment comparing survey modes and brochure enclosures

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Morgan M. Millar ◽  
Joanne W. Elena ◽  
Lisa Gallicchio ◽  
Sandra L. Edwards ◽  
Marjorie E. Carter ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Cancer Survivors ◽  
Cancer Registry ◽  
Patient Reported Outcomes ◽  
Web Surveys ◽  
Adjusted Risk ◽  
Adjusted Risk Ratio ◽  
Patient Reported ◽  
Paper Survey ◽  
Survey Modes

Abstract Background Central cancer registries are often used to survey population-based samples of cancer survivors. These surveys are typically administered via paper or telephone. In most populations, web surveys obtain much lower response rates than paper surveys. This study assessed the feasibility of web surveys for collecting patient-reported outcomes via a central cancer registry. Methods Potential participants were sampled from Utah Cancer Registry records. Sample members were randomly assigned to receive a web or paper survey, and then randomized to either receive or not receive an informative brochure describing the cancer registry. We calculated adjusted risk ratios with 95% confidence intervals to compare response likelihood and the demographic profile of respondents across study arms. Results The web survey response rate (43.2%) was lower than the paper survey (50.4%), but this difference was not statistically significant (adjusted risk ratio = 0.88, 95% confidence interval = 0.72, 1.07). The brochure also did not significantly influence the proportion responding (adjusted risk ratio = 1.03, 95% confidence interval = 0.85, 1.25). There were few differences in the demographic profiles of respondents across the survey modes. Older age increased likelihood of response to a paper questionnaire but not a web questionnaire. Conclusions Web surveys of cancer survivors are feasible without significantly influencing response rates, but providing a paper response option may be advisable particularly when surveying older individuals. Further examination of the varying effects of brochure enclosures across different survey modes is warranted.

scholarly journals Provider perspectives on the integration of patient-reported outcomes in an electronic health record

JAMIA Open ◽  
2019 ◽  
Vol 2 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Renwen Zhang ◽  
Eleanor R Burgess ◽  
Madhu C Reddy ◽  
Nan E Rothrock ◽  
Surabhi Bhatt ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Care Delivery ◽  
Psychosocial Care ◽  
Organizational Factors ◽  
Full Potential ◽  
Clinical Workflow ◽  
Provider Perspectives ◽  
Patient Reported ◽  
Individual Needs ◽  
Electronic Health

Abstract Objective Integrating patient-reported outcomes (PROs) into electronic health records (EHRs) can improve patient-provider communication and delivery of care. However, new system implementation in health-care institutions is often accompanied by a change in clinical workflow and organizational culture. This study examines how well an EHR-integrated PRO system fits clinical workflows and individual needs of different provider groups within 2 clinics. Materials and Methods Northwestern Medicine developed and implemented an EHR-integrated PRO system within the orthopedics and oncology departments. We conducted interviews with 11 providers who had interacted with the system. Through thematic analysis, we synthesized themes regarding provider perspectives on clinical workflow, individual needs, and system features. Results Our findings show that EHR-integrated PROs facilitate targeted conversation with patients and automated triage for psychosocial care. However, physicians, psychosocial providers, and medical assistants faced different challenges in their use of the PRO system. Barriers mainly stemmed from a lack of actionable data, workflow disruption, technical issues, and a lack of incentives. Discussion This study sheds light on the ecosystem around EHR-integrated PRO systems (such as user needs and organizational factors). We present recommendations to address challenges facing PRO implementation, such as optimizing data collection and auto-referral processes, improving data visualizations, designing effective educational materials, and prioritizing the primary user group. Conclusion PRO integration into routine care can be beneficial but also require effective technology design and workflow configuration to reach full potential use. This study provides insights into how patient-generated health data can be better integrated into clinical practice and care delivery processes.

scholarly journals Quality of life and mental health in breast cancer survivors compared with non-cancer controls: a study of patient-reported outcomes in the United Kingdom

2020 ◽  
Author(s):  
Helena Carreira ◽  
Rachael Williams ◽  
Harley Dempsey ◽  
Susannah Stanway ◽  
Liam Smeeth ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Primary Care ◽  
Cancer Survivors ◽  
Patient Reported Outcomes ◽  
Breast Cancer Survivors ◽  
Patient Reported ◽  
History Of ◽  
History Of Cancer

Abstract Purpose There is limited high-quality evidence on quality of life, anxiety, and depressive symptoms in breast cancer survivors and women with no history of cancer. We aimed to address this by comparing patient-reported outcomes between breast cancer survivors and women with no history of breast cancer. Methods Breast cancer survivors and women with no prior cancer were selected from the UK Clinical Practice Research Datalink GOLD primary care database, which includes population-based primary care electronic health record data. Breast cancer survivors and controls were frequency matched by age and primary care practice. Outcomes were assessed with validated instruments via postal questionnaire. Linear and logistic regression models were fitted to estimate adjusted associations between breast cancer survivorship and outcomes. Results A total of 356 breast cancer survivors (8.1 years post diagnosis) and 252 women with no prior cancer participated in the study. Compared with non-cancer controls, breast cancer survivors had poorer QoL in the domains of cognitive problems (adjusted β (aβ) = 1.4, p = 0.01), sexual function (aβ = 1.7, p = 0.02) and fatigue (aβ = 1.3, p = 0.01), but no difference in negative feelings, positive feelings, pain, or social avoidance. Breast cancer survivors had higher odds of borderline-probable anxiety (score ≥ 8) (adjusted OR = 1.47, 95%CI:1.15–1.87), but no differences in depression. Advanced stage at diagnosis and chemotherapy treatment were associated with poorer QoL. Conclusions Compared with women with no history of cancer, breast cancer survivors report more problems with cognition, sexual function, fatigue, and anxiety, particularly where their cancer was advanced and/or treated with chemotherapy. Implications for Cancer Survivors Breast cancer survivors with more advanced disease and/or treated with chemotherapy should be closely monitored and, when possible, offered evidence-based intervention for fatigue, cognitive dysfunction, and sexual problems.

Methodologic Considerations for Collecting Patient-reported Outcomes from Unselected Surgical Patients

2016 ◽  
Vol 125 (3) ◽  
pp. 495-504 ◽  
Author(s):  
Daniel L. Helsten ◽  
Arbi Ben Abdallah ◽  
Michael S. Avidan ◽  
Troy S. Wildes ◽  
Anke Winter ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Patient Reported Outcomes ◽  
Query Language ◽  
Preoperative Assessment ◽  
Surgical Patients ◽  
Clinical Workflow ◽  
Patient Reported ◽  
The Impact ◽  
E Mail

Abstract Background The impact of surgery on health is only appreciated long after hospital discharge. Furthermore, patients’ perceptions of postoperative health are not routinely ascertained. The authors instituted the Systematic Assessment and Targeted Improvement of Services Following Yearlong Surgical Outcomes Surveys (SATISFY-SOS) registry to evaluate patients’ postoperative health based on patient-reported outcomes (PROs). Methods This article describes the methods of establishing the SATISFY-SOS registry from an unselected surgical population, combining perioperative PROs with information from electronic medical records. Patients enrolled during their preoperative visit were surveyed at enrollment, 30 days, and 1-yr postoperatively. Information on PROs, including quality of life, return to work, pain, functional status, medical complications, and cognition, was obtained from online, mail, or telephone surveys. Results Using structured query language, 44,081 patients were identified in the electronic medical records as having visited the Center for Preoperative Assessment and Planning for preoperative assessment between July 16, 2012, and June 15, 2014, and 20,719 patients (47%) consented to participate in SATISFY-SOS. Baseline characteristics and health status were similar between enrolled and not enrolled patients. The response rate for the 30-day survey was 62% (8% e-mail, 73% mail, and 19% telephone) and for the 1-yr survey was 71% (13% e-mail, 78% mail, and 8% telephone). Conclusions SATISFY-SOS demonstrates the feasibility of establishing a PRO registry reflective of a busy preoperative assessment center population, without disrupting clinical workflow. Our experience suggests that patient engagement, including informed consent and multiple survey modalities, enhances PROs collection from a large cohort of unselected surgical patients. Initiatives like SATISFY-SOS could promote quality improvement, enable efficient perioperative research, and facilitate outcomes that matter to surgical patients.

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