Patient engagement with a portal-based symptom management program across six health systems.

Abstract

351 Background: Collecting patient-reported outcomes (PROs) improves quality of life and self-efficacy, reduces acute care needs, and extends survival for cancer patients. Prior studies evaluating the efficacy of PROs have often relied on unrepresentative populations seen at well-resourced health systems and treated in controlled settings. As a result, widespread PRO implementation has not been achieved. We sought to study the reach of an electronic PRO-based, EHR-integrated symptom management system (eSyM) that was deployed in routine clinical practice across six diverse health systems. Methods: All patients receiving medical oncology (MO) or surgical (SURG) care for a confirmed or suspected gastrointestinal, gynecologic, or thoracic malignancy were invited to use eSyM – a patient portal-based tool that asks patients to respond to symptom questionnaires, provides symptom management resources, and fosters patient-clinician communication. Study outcomes included any portal use, sending a message via the portal, and completing an eSyM symptom questionnaire via the portal. Spearman coefficients were used to assess the correlation between portal message use and eSyM questionnaire completion. Multivariable logistic regression models were used to identify factors associated with completing at least one eSyM questionnaire. Results: From September 2019 to March 2023, 9589 MO and 13,297 SURG patients had access to eSyM. Patient characteristics and usage rates were analyzed [Table]. Among portal users, most patients accessed it via the web app only, with 39.2% of MO and 42.6% of SURG patients accessing it via both the web and mobile apps. Correlations between message use and questionnaire use were moderate (0.48 for MO, 0.43 for SURG). Notably, 17.9% of MO and 21.7% of SURG patients sent a portal message but did not submit an eSyM questionnaire. Factors associated with lower odds of eSyM questionnaire completion for both the MO and SURG cohorts included: older age, male sex, Black race, Medicaid insurance, and being single, widowed, or disabled. Conclusions: In a diverse patient population from six community-based cancer centers, over 80% used the portal for any reason, over 58% sent a message, and over 46% submitted at least one eSyM questionnaire. Strategies that improve patient engagement and ameliorate disparities with ePRO-based programs are needed. Some eSyM non-responders never used the portal, whereas others used the portal for different reasons, suggesting that technical and non-technical barriers to ePRO programs exist.[Table: see text]