Despite incredible treatment advances over the past several decades, no single phrase has more power to fundamentally transform people’s lives like “you have cancer.”
Even the most engaged patients can “tune out” after a diagnosis, retreating into a world of disbelief and the possibility of negative outcomes. That fog often continues during treatment, as surgical interventions, chemotherapy, radiation, and immunotherapy disrupt daily lives, potentially resulting in life-altering and permanent side effects.
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While patients struggle with treatment side effects, they often hesitate to call the clinic for fear of bothering their care team. From the nurse’s station, the back-and-forth communication, phone tag, and email exchange in an attempt to capture patients’ symptoms is not only frustrating and time-consuming, but it can delay intervention and leave patients sick to the point they seek care in the emergency department.
The rise of electronic patient-reported outcomes (ePRO) tools enables patients to report their symptoms from home, alleviating any concern about burdening the clinic through constant phone calls. With self-reporting, clinics can extend healing into patients’ homes by delivering disease-specific surveys that monitor symptom severity in a way that alerts medical staff to patients with new or worsening symptoms, indicative of an adverse event. In addition to empowering patients to take an active role in their care journey, active symptom monitoring can improve patient outcomes, and satisfaction, enable clinicians to pre-empt adverse events, and reduce clinician burnout.
App puts patients at the center of their treatment
Although cancer treatments have become more standardized through treatment guidelines, not every patient, their health history, their preferences, or their cancer is the same. A well-tolerated treatment for one patient can bring debilitating side effects for another. Being able to tailor treatments to patients based on their unique situation and preferences forces clinicians to deviate from guidelines and use intuition, rather than data. But when clinicians have a direct line into real-time patient symptom data, they are armed with more than a gut feeling to make personalized treatment decisions.
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Continuous symptom monitoring using ePRO tools empowers patients to take charge of their symptoms while providing valuable data to clinicians to intervene when necessary. ePROs provide more than solely giving patients the ability to report their symptoms electronically from the comfort of their home – some ePROs have the ability to provide patients with personalized educational resources while they await a response from their care team. Additionally, there are ePROs that can be configured even further at the patient level, giving their care team the ability to choose which symptoms they report and how often they report them based on their treatment plan. ePROs are a key tool in the push to realize personalized medicine in oncology.
Engagement can lead to better patient outcomes
Empowering patients in their healthcare is considered a fundamental aspect of patient-centered care and has the potential to transform the healthcare experience for both the patient and their care team.
Patient engagement has been linked to better health outcomes, as they are more likely to adhere to treatment plans and medications, leading to improved disease management and prevention of complications.
Effective, shared decision-making starts with a good relationship between patients and their care team. By creating an environment where information is shared openly, patients feel supported and encouraged to express their treatment preferences.
Empowered patients are more informed about their conditions and treatment options, which enables them to make decisions that align with their values and preferences. ePRO tools can help facilitate this dialog through symptom monitoring, relevant and appropriate education, and the ability of patients to review their responses to potentially help them understand how well they tolerate or don’t tolerate certain treatments or symptom interventions.
A randomized, published study of patient-reported outcomes among cancer patients receiving chemotherapy shows that symptom monitoring:
- Improves quality of life by 88%
- Reduces ED visits by 17%
- Increases chemotherapy adherence by 30%
- Increases patient survival by 8%
Empowered patients feel supported by the knowledge that staff are monitoring their symptom reports and stand ready to intervene, if necessary, should symptoms threaten their health or could possibly result in an emergency room visit. More than 90% of patients using a cancer-specific ePRO tool express satisfaction with the app.
Saving clinicians time while caring for patients
Symptoms of burnout among clinicians were already high before the pandemic hit. A survey from the American Society of Clinical Oncology (ASCO) showed that 45% of medical oncologists “had experienced classic symptoms of burnout, including emotional exhaustion and depersonalization/detachment.” Burnout doesn’t just affect oncologists, it affects every member of the care team. Another ASCO survey showed that oncologists worked an average of 57.6 hours a week while seeing a mean of 52 outpatients.
Adequately caring for patients takes more time, but the preponderance of EHRs has resulted in increased work for physicians. A study utilizing 2019 data shows that physicians spend an average of 1.84 hours daily performing documentation tasks outside of work hours.
Electronic symptom monitoring not only empowers patients, it also relieves clinicians of many charting duties that can take considerable time to complete. Instead of a nurse calling every patient who just started post-surgical treatment to check on potential side effects, self-reporting tools allow care teams to monitor symptoms remotely. Rather than individually checking in with the entire cohort, care teams can follow up with patients who report adverse reactions, which saves considerable time and eliminates much of the communication back and forth that frustrates both patients and providers.
By monitoring the patient population using ePRO tools, physicians can focus on patients who require intervention for their symptoms or may need treatment modification. Anecdotally, using ePRO tools can save physicians as many as 55 clicks within an EHR, per patient.
Improve quality of life for patients — and clinicians
A cancer diagnosis sets off a cascade of next steps, including additional tests, consults, surgery, follow-up visits, chemotherapy, and more. It’s no wonder that oncologists say that patients often have difficulty digesting their diagnosis and understanding next steps— it’s just too much information at one time.
Using electronic patient-reported outcomes tools empowers patients to take charge of their own symptom management, reassured that they aren’t alone on the journey through side effects and pain management. ePRO tools have been shown to improve not only the patient’s quality of life but also the work life balance for oncologists and their care team through speedier and more efficient processes.
Photo: andreswd, Getty Images
Celena Wheeler is Vice President of Product Management at Project Ronin.
