Abstract
Background
Oncology practice can be enhanced by the integration of the assessment of patient‐reported symptoms and concerns into the electronic health record (EHR) and clinical workflows.
Methods
Adult oncology outpatients (n = 6825) received 38,422 invitations to complete assessments through the EHR patient portal. Patient‐Reported Outcomes Measurement Information System computer adaptive tests were administered to assess fatigue, pain interference, physical function, depression, and anxiety. Checklists identified psychosocial, nutritional, and informational needs. In real time, assessment results were populated in the EHR, and clinicians were notified of elevated symptoms and needs.
Results
In all, 3521 patients (51.6%) completed 8162 assessments; approximately 55% of the responding patients completed 2 or more within 32 months. Fatigue, pain, anxiety, and depression scores were comparable to those of the general population (approximately 5% of assessments triggered clinical alerts across those domains); mean scores indicated a lower level of physical function (with severe scores prompting alerts in nearly 5% of assessments). More than half of assessments triggered an alert based on patient endorsement of supportive care needs, with the majority of those being nutritional (41.82% of assessments). Patient endorsement of supportive care needs was associated with significantly higher anxiety, depression, fatigue, and pain interference scores and lower physical function scores. Patients who triggered clinical alerts tended to be younger and more recently diagnosed, to have greater comorbidities, and to be a racial/ethnic minority. Patients who triggered clinical alerts had more health care service encounters in the ensuing month.
Conclusions
EHR integration facilitated the assessment and reporting of patient‐reported symptoms and needs within routine oncology outpatient care.
More than 3500 oncology outpatients completed assessments of priority symptoms and supportive care needs through an electronic health record patient portal. Assessment results were immediately populated in the electronic health record, with clinicians notified of elevated symptoms and needs through electronic health record messages. This facilitated responding to patients in real time.
