Framework for integrating electronic patient-reported data in routine cancer care: an Oncology Intake Questionnaire

Abstract

Objective As part of ongoing implementation of electronic patient-reported outcome tools at the Dana-Farber Cancer Institute, here we describe the development of the electronic New Patient Intake Questionnaire. Materials and Methods The original New Patient Intake Questionnaire includes a review of symptoms, oncology history, family history, health behaviors, health and social status, health literacy and numeracy, which was modified for integration into the EHR using content determination, build and configuration, implementation, analytics, and interventions. The engagement of key stakeholders, including patients, clinical staff, and providers, throughout the development and deployment of the electronic Questionnaire was crucial to producing a successful tool. Continual modifications based on input of stakeholders (such as mode of tool deployment) were made to ensure the utility and usability of the tool for both patients and providers. Results Implementation of the EHR-integrated electronic New Patient Intake Questionnaire improved collection of the PRD by increasing questionnaire accessibility for patients, while also providing all available data to clinicians and researchers. Careful consideration of the content and configuration of the questionnaire allowed for a successful, institute-wide implementation of the tool. Discussion This effort demonstrates the feasibility of implementation of a system-wide electronic questionnaire, emphasizing the importance of iterative refinement to create a tool that is both patient-centric and usable for clinicians. Conclusions The electronic New Patient Intake Questionnaire allows for systematic collection of the PRD, which should benefit cancer care outcomes through innovative care delivery and healthcare interventions.

Examining disparities in large‐scale patient‐reported data capture using digital tools among cancer patients at clinical intake

“…Moffitt patient portal usage and EPQ completion rates have been consistently high among NPs seen at Moffitt since 2014, averaging 81% and 79%, respectively, notably higher than rates historically reported by others, 7,24 although consistent with more recent portal usage that has increased with the expansion of telehealth following the COVID‐19 pandemic 25–28 . The Moffitt patient portal provides patients with access to several services relevant to clinical care (e.g., scheduling) and encourages advanced completion of clinically relevant patient forms such as the EPQ, which may contribute to high completion rates.…”

“… 25 , 26 , 27 , 28 The Moffitt patient portal provides patients with access to several services relevant to clinical care (e.g., scheduling) and encourages advanced completion of clinically relevant patient forms such as the EPQ, which may contribute to high completion rates. In addition, the availability of the EPQ via tablet in the clinic also serves to optimize completion rates, 7 particularly among patients accessing emergent care.…”

“…Prior studies demonstrate that collecting patient‐reported data can improve health outcomes, reduce adverse events, and expand access to care. 4 , 5 , 6 Specifically, some cancer centers have developed enterprise‐wide 7 , 8 , 9 or clinic‐specific 10 intake forms to collect pertinent patient‐reported data prior to a patient's first visit. Equitable participation in these data collection efforts is essential for ensuring that all patients receive patient‐centered care.…”

FASTOCH: Feasibility of Electronic Patient-Reported Outcomes in Older Patients With Cancer—A Multicenter Prospective Study

“…Such an option may, however, limit the efficacy of ePROs, as patients would not be able to use this tool to report symptoms in real time when they are off-site. 26 It may therefore be worth lending connected tablets to patients so that they can complete ePROs at home, as has been done in other studies, 15,27,28 especially because this improved the ePRO completion rate. 27 Another alternative could be to train nurses to help patients to complete ePROs at home, as another study observed that 63% of their patients age 80 years or older had needed assistance to complete remote ePRO assessments.…”

“…26 It may therefore be worth lending connected tablets to patients so that they can complete ePROs at home, as has been done in other studies, 15,27,28 especially because this improved the ePRO completion rate. 27 Another alternative could be to train nurses to help patients to complete ePROs at home, as another study observed that 63% of their patients age 80 years or older had needed assistance to complete remote ePRO assessments. 29 Yet again patients would not be able to complete ePROs whenever they would feel like they need to report symptoms, and this could hinder the benefit of this monitoring.…”