Use of an automated notification tool to drive real-time patient symptom intervention.

Abstract

160 Background: Cancer Treatment Centers of America, Inc. (CTCA) is a national network of hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients’ perceived symptom burden for real-time clinical intervention, from baseline and every 21 days thereafter. The SIT is comprised of questions utilizing the M.D. Anderson Symptom Inventory tool, a validated assessment instrument with questions added and a free text box by CTCA. Methods: An e-mail notification system associated with the SIT was established to allow efficient communication with specialists and support team members who would not traditionally see the patient without such a trigger signifying a need. While the SIT report is housed within the EHR, an automated e-mail profile may be established for each clinician and or team, tailored to the clinical specialty, based on symptom(s) of interest. Patients completing the SIT and scoring a particular symptom(s) at or above a threshold will “trigger” notification of that their score along with information allowing follow-up. Notifications can be set at 15 minute intervals, hourly, daily, etc. Results: 31 users/groups, representing a wide variety of disciplines and multiple care teams, currently utilize the SIT e-mail functionality including: Pain, Distress, Mind Body Medicine, Survivorship, Physical Therapy, and Sleep. The content of the e-mail consists of the patient name, medical record number, and (self-defined) symptom scores of interest. These same patients triggering a notification may be readily tracked for follow-up by the support team throughout their course of treatment or seen only once depending upon patient preference and identified need. Conclusions: The e-mail notification process has promoted communication with specialists and other support team members outside of the core team, cognizant of their different communication needs. Moreover, it allows for effective alignment of resources based on clinician expertise.