Electronic Patient-Reported Outcomes in Oncology: Lessons from Six Cancer Centers

Abstract

Summary Research has demonstrated that among cancer patients who experience high symptom burden, electronic patient-reported outcomes (ePROs) improve physician–patient communication, reduce acute care utilization, and extend survival. The SIMPRO (Symptom Management Implementation of Patient-Reported Outcomes in Oncology) Research Consortium partnered with the electronic health record (EHR) vendor Epic to create Electronic Symptom Management (eSyM), an EHR-integrated toolkit promoting prospective symptom management. Since 2019, eSyM has been integrated into routine care at the six SIMPRO Research Consortium health systems. As of June 2023, eSyM has been assigned to 25,358 patients receiving care in more than 50 clinics at SIMPRO sites. Of these, 48% of the patients have used eSyM at least once to report symptoms. More than 92,000 questionnaires have been completed, with 16% recording at least one severe symptom. Patient adoption was challenging due to technical constraints, lack of program understanding, and uncertainty about care team utilization. Clinician eSyM implementation was challenging because of numerous competing demands, staffing issues, and perceptions that eSyM would be burdensome. eSyM implementation was facilitated by deploying an evidence-based, centrally built, EHR-integrated system; engaging a collaborative group of champions and staff from the clinical, operational, and technical teams at each health system; providing centralized project management support; and educating patients and nurses using tailored approaches that considered the unique aspects of each health system. The experiences of these health systems and patients could inform the future scaling of eSyM across different health systems and of ePRO-based programs for other medical conditions.