Patient Reported Outcome Measure (PROM) Collection Rates When Part of Routine Clinical Workflow in an Academic Radiation Oncology Department

Abstract

Patient reported outcome measures (PROMs) are tools, usually questionnaires, that measure patient reported outcomes (PROs), directly recording a patient's health status and symptoms without interpretation by clinicians. Use of PROs can improve patient survival, quality of life, and financial toxicity. The goal of this study was to assess the collection rate of PROs in our academic radiation oncology department since implementing an electronic PROs collection system as a part of routine clinical care in 2016. Our hypothesis was that we could collect PROs from a significant proportion of our patients using digital tools without significantly changing our clinical workflows.Patients were assigned cancer-specific PROMs by their clinicians, and could submit answers by using a tablet provided in clinic or by using our electronic health record (EHR)-associated patient portal on a computer or mobile device (tablet or phone). We analyzed the collection rate of PROs from adult patients who received care in our department between March 2016 and March 2020. A Chi-squared test was used to compare groups.In total, we requested 216,842 PROMs from 22,471 patients (43% male, 57% female) from 176,904 visits. We received 127,686 PROMs from 77,689 encounters (43.9%) where patients were assigned at least one questionnaire. Among the collected PROMs (where at least one question was answered), 72% were answered completely. The number of collected PROMs increased over time, and the completely answered rate also increased over time. Patients who were more likely to answer PROMs were female, white, married or had a civil union or life partner, lived in-state, spoke English, had completed fewer years of schooling, and had a work status of full time or not retired or disabled. Most surveys were collected using a tablet in clinic (94%) from patients with breast (33%), genitourinary (19%), or thoracic (14%) malignancies during on treatment visits (54%). All P-values for described patterns were < 0.001.PROs can be collected with relatively high rates from all patients in an academic radiation oncology department, though variations exist. This suggests that more radiation oncology clinics should try to incorporate PROs into routine patient care if they have sufficient resources. Implementation strategies should be shared among institutions, especially if they share EHR vendors.