Remote monitoring after hospital discharge.

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561 Background: Strategies to improve transitions from the hospital to home for patients with cancer are considered an important component of quality, patient-centered care in oncology. CMS evaluates cancer hospital performance based on the 30-day unplanned hospital readmission rate, and this measure has been endorsed by the National Quality Forum. Nationally, the 30-day readmission rate for oncology patients ranges from 19%-27%. These readmissions come at high psychosocial, physical, and financial costs for patients and caregivers. A remote monitoring intervention that includes frequent contacts with the patient is likely to be effective in improving this transition. Methods: We evaluated the feasibility, acceptability, and perceived value of a mobile health intervention to monitor and manage symptoms of adult medical oncology patients discharged from an NCI-designated cancer center to home. Patients were monitored for 10 days, which is the median time to readmission for an oncology patient. The technology supporting the program included: 1) a patient portal enabling daily electronic patient-reported outcomes assessments; 2) alerts for concerning symptoms; 3) an application to allow staff to review and trend symptom data; 4) a secure platform to support communications and televisits between staff and patients; 5) an advanced feedback report to provide just-in-time patient symptom education. Feasibility and acceptability were evaluated through engagement (goal: >50% response rate) and symptom alerts and perceived value was measured through a patient engagement survey that included a net promoter score (how likely the patient is to recommend the program to similar patients; goal >0.70). Results: Between January 1, 2021 to December 31, 2022, the program enrolled 2,258 medical oncology patients (median age: 63 years, 55% female). Patients with gastrointestinal (25%) and thoracic (19%) malignancies were the most prevalent diagnoses. Of those enrolled, 66% of patients participated in home remote monitoring by self-reporting symptom data and 49% of patients generated a severe symptom alert. The most prevalent severe symptom alerts were pain (24%), constipation (7%), and fatigue (7%). Patients expressed a great deal of satisfaction with the intervention with a net promoter score of 0.86. In preliminary analysis, we found that 30-day readmission decreased by 3% (from 33% to 30%) representing savings of $2.3 - $5.8 MM annually. Conclusions: A remote monitoring program after discharge was feasible, acceptable, and perceived to be of value by oncology patients discharged from a cancer center. Future work will evaluate the value of a remote symptom monitoring platform in decreasing readmissions.