Cancer Care Team's Management of Clinical Alerts Generated by Electronically Collected Patient Reported Outcomes: We Could Do Better

Orlando Rincones; Adeola Bamgboje-Ayodele; Anthony Arnold; Geoff P Delaney; Ivana Durcinoska; Sandra Avery; Tiffany Sandell; Stephen A Della-Fiorentina; Joanne Pearson; The Prompt-Care Co-Authorship Group; Afaf Girgis

doi:10.3390/ijerph20032001

Cancer Care Team's Management of Clinical Alerts Generated by Electronically Collected Patient Reported Outcomes: We Could Do Better

Int J Environ Res Public Health. 2023 Jan 21;20(3):2001. doi: 10.3390/ijerph20032001.

Authors

Affiliations

¹ Ingham Institute for Applied Medical Research, South West Sydney Clinical Campuses, UNSW Medicine & Health, University of New South Wales, Liverpool, NSW 2170, Australia.
² Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
³ Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW 2500, Australia.
⁴ Liverpool Cancer Therapy Centre, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia.
⁵ School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia.
⁶ Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW 2116, Australia.

Abstract

Electronically administered patient-reported outcome measures (ePROMs) are effective digital health tools for informing clinicians about cancer patients' symptoms and facilitating timely patient-centred care. This paper describes the delivery of healthcare activities supported by the PROMPT-Care model, including ePROMs generated clinical alerts, cancer care team (CCT) response to alerts, and patients' perceptions of the CCT response and ePROMs system. This mixed-methods study includes cancer patients from four cancer therapy centres in New South Wales, Australia. Quantitative and qualitative data were collected regarding clinical alert activity, CCT response, and patient perceptions of the CCT responses and ePROMs system. Qualitative data were thematically analysed. Of the 328 participants whose care was informed by the digital health tool, 70.8% (n = 233) generated at least one alert during the trial period, with 877 alerts generated in total. Although 43.7% (n = 383) were actioned by the CCT, at least 80% of participants found follow-up CCT phone calls beneficial, with multiple benefits confirmed in interviews. The cancer care delivery arm of the PROMPT-Care trial involving clinical alerts to the CCT was positively perceived by most participants, resulting in a diverse range of benefits. However, further work is required, informed by implementation science, to improve the percentage of actioned clinical alerts.

Keywords: cancer; cancer care coordinators; clinical alerts; eHealth; electronic patient reported outcome measures (ePROMs); patient-centred care; referrals; symptom screening.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Delivery of Health Care
Humans
Neoplasms* / therapy
Patient Care Team
Patient Reported Outcome Measures

Grants and funding

This research was funded by the Cancer Institute New South Wales (CINSW), BUPA Health Foundation, South Western Sydney Local Health District, and Wollondilly Health Alliance. AG was funded through Cancer Institute grants.