No abstract

Background: We developed SPHERE, an electronic health record (EHR) data visualization application, to automatically populate with EHR data on the American Heart Association’s cardiovascular health (CVH) behaviors and factors. SPHERE was designed to increase patient-provider communication around Life’s Simple 7™, and utilized a stoplight color scheme as part of the visualization to indicate “ideal” (green), “intermediate” (yellow), and “poor” (red) CVH. Results from the SPHERE Study showed improvements in body mass index and diabetes status among eligible patients seen in the intervention clinic as compared to the control clinic. It remains unknown whether the use of SPHERE would be acceptable to oncologists in the survivorship care setting, even though cancer survivors are at high risk for developing cardiovascular disease. Methods: We conducted one-on-one interviews, using a think-aloud protocol, with 14 oncologists (10 community practice, 4 academic) who were practicing in the NCI Community Oncology Research Program (NCORP). During the 30-minute interview period, we asked each oncologist to use SPHERE and we obtained user feedback on the SPHERE application. Results: Half of the oncologists were male, and most (78%) were medical oncologists; 2 were gynecologic oncologists, and 1 was a radiation oncologist. When asked about discussing CVH with post-treatment, good-prognosis patients, no oncologists indicated that they “never” talked to patients about CVH or initiated those discussions. Eleven oncologists responded that discussing CVH was either “somewhat important” or “very important”, and 9 oncologists indicated they were “somewhat comfortable” or “very comfortable” discussing CVH with patients. Themes identified from transcripts of the 7 hours of interviews suggest 1) strong interest in the tool, 2) high perceived importance of discussing CVH with patients who had a good prognosis, 3) high usability, and 4) a belief that the tool would be helpful and not overly burdensome in practice. Duplication of preventative health efforts with the primary care provider as well as workflow and time constraints were identified as barriers by several oncology providers. Conclusions: Overall, these preliminary data demonstrate acceptability and feasibility of implementing the SPHERE application tool within NCORP community oncology practices. These qualitative data suggest great potential for automated EHR-based applications such as SPHERE to impact the CVH of cancer patients in survivorship care.