Using an ePRO tool to help meet quality metrics in a clinical oncology practice.

Abstract

171 Background: ASCO has implemented the Quality Oncology Practice Initiative (QOPI), a certification program established to evaluate oncology practice performance. However, practices often lack the necessary resources to meet the required standards and fulfill required metric reporting. The study purpose was to document the effectiveness of using an electronic Patient Reported Outcome (ePRO) system to facilitate compliance with two QOPI standards: pain assessment and depression screening. Methods: This study used a retrospective, observational design with ePRO and clinical data collected via the Patient Care Monitor (PCM), a web-based ePRO system linked to electronic medical record data. All study data were collected as part of routine clinical care at a community oncology practice during a 4-month interval (1/1–4/26/19). Patients at an initial oncology clinic visit completed the PCM Core Symptom survey and the PHQ2/PHQ9 to screen for pain and depression respectively via a handheld e-tablet. Results: Overall, 10,449 patients completed the PCM survey (mean age 63; 30% male/70% female; 62% White, 34% Black). Cancer type was known for 53% of all patients (22% breast, 9% hematologic, 4% lung, 5% colorectal, 3% prostate, 11% other types). Fifteen percent of patients (n = 1584) met the pain threshold (scored 7 or above on a 0-10 scale) that signaled an alert to the physician for further evaluation. About 3% of patients (n = 413) skipped the pain question on the PCM Core Symptom survey. With respect to depression, 5% (n = 559) reported a PHQ2 threshold level that triggered the remaining PHQ9 items. Among those at higher risk for depression, 16% (n = 92) met criteria for moderate to severe depression warranting further clinical evaluation and the PCM signaled a real-time alert to the physician in advance of the patient consultation. Approximately 4% (n = 413) skipped the PHQ2. Conclusions: This study demonstrates that using an ePRO system is an effective way to screen for pain and depression and can be used to: 1) monitor symptoms to enhance physician-patient communication during the consultation; 2) provide an audit trail for QOPI metric reporting. Overall, an ePRO system contributes to creating a culture of excellence at community oncology practices.