Implementation and Feasibility of an Electronic Health Record–Integrated Patient-Reported Outcomes Symptom and Needs Monitoring Pilot in Ambulatory Oncology
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PURPOSE: Describe the feasibility and implementation of an electronic health record (EHR)–integrated symptom and needs screening and referral system in a diverse racial/ethnic patient population in ambulatory oncology. METHODS: Data were collected from an ambulatory oncology clinic at the University of Miami Health System from October 2019 to January 2021. Guided by a Patient Advisory Board and the Exploration, Preparation, Implementation, and Sustainment model, My Wellness Check was developed to assess physical and psychologic symptoms and needs of ambulatory oncology patients before appointments to triage them to supportive services when elevated symptoms (eg, depression), barriers to care (eg, transportation and childcare), and nutritional needs were identified. Patients were assigned assessments at each appointment no more than once in a 30-day period starting at the second visit. Assessments were available in English and Spanish to serve the needs of the predominantly Spanish-speaking Hispanic/Latino population. RESULTS: From 1,232 assigned assessments, more than half (n = 739 assessments; 60.0%) were initiated by 506 unique patients. A total of 65.4% of English and 49.9% of Spanish assessments were initiated. Among all initiated assessments, the majority (85.1%) were completed at home via the patient portal. The most common endorsed items were nutritional needs (32.9%), followed by emotional symptoms (ie, depression and anxiety; 27.8%), practical needs (eg, financial concerns; 21.7%), and physical symptoms (17.6%). Across the physical symptom, social work, and nutrition-related alerts, 77.1%, 99.7%, and 78.8%, were addressed, respectively, by the corresponding oncology health professional, social work team member, or nutritionist. CONCLUSION: The results demonstrate encouraging feasibility and initial acceptability of implementing an EHR-integrated symptom and needs screening and referral system among diverse oncology patients. To our knowledge, this is the first EHR-integrated symptom and needs screening system implemented in routine oncology care for Spanish-speaking Hispanics/Latinos.
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Proactive screening and management of treatment-related side effects can improve needs assessment.
“a proactive screening and management of treatment-related side effects can improve needs assessment46 and symptom control.47”
From Implementing a PROACTive Care Pathway to Empower and Support Survivors of Breast Cancer (2023) · cites this paper as [46]
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Implementing a PROACTive Care Pathway to Empower and Support Survivors of Breast Cancer
Franzoi, M. A., Degousée, L., Martin, E., Semedo, P. M., Aupomerol, M., Soldato, D., Di Meglio, A., Chiodi, C., Barbier, A., Chaouachi, H., et al. (2023) · JCO Oncology Practice · doi:10.1200/op.23.00016 · Cited by 18 · see citing works
- Authors
- Penedo, F. J., Medina, H. N., Moreno, P. I., Sookdeo, V., Natori, A., Boland, C., Schlumbrecht, M. P., Calfa, C., MacIntyre, J., Crane, T. E., & Garcia, S. F.
- Affiliations
- University of Miami (US)
- Sylvester Comprehensive Cancer Center (US)
- Northwestern University (US)
- Corresponding author
- Penedo, Frank J.
- ORCID
- Venue
- JCO Oncology Practice
- Published
- 2022-07
- Volume
- 18
- Issue
- 7
- Pages
- e1100-e1113
- ISSN
- 2688-1527 (ISSN-L)
- 2688-1535
- PMC
- PMC9287298
- OpenAlex
- W4220748522
- Cited by
- 39
- References
- 52
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 9 · 2023: 11 · 2022: 5
- FWCI
- 6.17
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- JCO Oncology Practice (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (R18HS026170, R18HS026170-01)
- National Cancer Institute (K01CA258955, P30CA240139)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Diagnosis and Documentation
- Keywords
- electronic health record integration, patient-reported outcomes, symptom screening, needs assessment, outpatient oncology, supportive care, patient portals, Spanish-speaking patients, Hispanic patients, anxiety and depression, nutrient requirements, social work referral, barriers to care, implementation feasibility
- MeSH terms
- Patient Reported Outcome Measures, Feasibility Studies, Humans, Medical Oncology, Neoplasms, Electronic Health Records
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