Using the Computer-based Health Evaluation System (CHES) to Support Self-management of Symptoms and Functional Health: Evaluation of Hematological Patient Use of a Web-Based Patient Portal

Abstract

Background Patient portals offer the possibility to assess patient-reported outcome measures (PROMs) remotely, and first evidence has demonstrated their potential benefits. Objective In this study, we evaluated patient use of a web-based patient portal that provides patient information and allows online completion of PROMs. A particular focus was on patient motivation for (not) using the portal. The portal was developed to supplement routine monitoring at the Department of Internal Medicine V in Innsbruck. Methods We included patients with multiple myeloma and chronic lymphocytic leukemia who were already participating in routine monitoring at the hospital for use of the patient portal. Patients were introduced to the portal and asked to complete questionnaires prior to their next hospital visits. We used system access logs and 3 consecutive semistructured interviews to analyze patient use and evaluation of the portal. Results Between July 2017 and August 2020, we approached 122 patients for participation in the study, of whom 83.6% (102/122) consented to use the patient portal. Patients were on average 60 (SD 10.4) years old. Of patients providing data at all study time points, 37% (26/71) consistently used the portal prior to their hospital visits. The main reason for not completing PROMs was forgetting to do so in between visits (25/84, 29%). During an average session, patients viewed 5.3 different pages and spent 9.4 minutes logged on to the portal. Feedback from interviews was largely positive with no patients reporting difficulties navigating the survey and 50% of patients valuing the self-management tools provided in the portal. Regarding the portal content, patients were interested in reviewing their own results and reported high satisfaction with the dynamic self-management advice, also reflected in the high number of clicks on those pages. Conclusions Patient portals can contribute to patient empowerment by offering sought-after information and self-management advice. In our study, the majority of our patients were open to using the portal. The low number of technical complaints and average time spent in the portal demonstrate the feasibility of our patient portal. While initial interest was high, long-term use was considerably lower and identified as the main area for improvement. In a next step, we will improve several aspects of the patient portal (eg, including a reminder to visit the portal before the next appointment and closer PROM symptom monitoring via an onconurse).

Usability of Electronic Patient-Reported Outcome Measures for Older Patients With Cancer: Secondary Analysis of Data from an Observational Single Center Study

“…Considering that the average completion time of the paper-pencil version of the QLQ-C30 is around 11 minutes [ 54 ], this highlights that ePRO assessments can be more time-efficient and potentially easier to use if support is supplied to those patients who need it. The average completion time of 4.9 (SD 3.20) minutes is similar to other studies that measured the time of electronic completion for the QLQ-C30 [ 55 , 56 ]. Another finding was that patients needed less time to complete the questionnaire at the second assessment, indicating a potential learning effect.…”

Adherence to Patient-Reported Symptom Monitoring and Subsequent Clinical Interventions for Patients With Multiple Myeloma in Outpatient Care: Longitudinal Observational Study

“…PROMs are administered through the Computer-based Health Evaluation System (CHES) using a remote, web-based patient portal, in which patients complete PROMs before and during patient visits at the outpatient unit [ 21 ]. In the portal, patients can access their scores and corresponding self-management advice [ 20 ]. The PROMs assessment is part of the Austrian Myeloma Registry (AMR) [ 19 ].…”

“…PROMs are completed either remotely before or during patients’ visits every few weeks at the outpatient unit. We found that symptom monitoring is feasible and relevant for patients with Multiple Myeloma [ 19 , 20 ]. Patients’ feedback, however, suggested that more regular assessments supported by reminders and systematic screening of the results by health care professionals in-between patient visits could increase adherence and patient experience [ 20 ].…”

Usability evaluation of the Computer-Based Health Evaluation System (CHES) eDiary for patients with faecal incontinence: a pilot study

“…The eDiary was developed to enable the comprehensive patient-reported assessment of FI and bowel movements in clinical routine and for clinical trials. We used the Computer-based Health Evaluation System (CHES) [ 26 – 28 ] as a software basis to develop an iOS and Android app that can be downloaded on most mobile devices. Alternatively, the app can also be accessed via any web browser (no installation needed), although this way it does not offer all of the same features (e.g., no push notifications).…”