Evaluate implementation of navigator-delivered Home ePRO for all cancer patients across multiple practice sites and assess the impact of Home ePRO on clinical and utilization outcomes.
Randomized controlled trials demonstrated that weekly electronic home-based PRO symptom monitoring with automated alerts to clinicians (Home ePRO) in cancer patients was associated with reduced healthcare utilization, improved quality of life, and increased overall survival. However, these trials were administered using infrastructure supported by research funding. A knowledge gap remains about optimal implementation strategies for and effectiveness of Home ePROs in real-world settings. To address this gap, we will conduct a large-scale population-based implementation of an evidence-based Home ePRO intervention for all adult cancer patients receiving chemotherapy. The investigators' hypothesis is that the implementation of navigator-delivered Home ePRO will be successful and will improve both patient and health system outcomes.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
3,090
The intervention includes standard of care weekly symptom survey delivery to patients, with alerts generated for symptoms that are sent to clinic nurses to address per standard of care protocol
University of Alabama at Birmingham
Birmingham, Alabama, United States
Service Penetration
% of eligible patients enrolled
Time frame: up to 3 months of starting a treatment for cancer
Proportion of Alerts Closed Within 48 Hours
alerts are measured by abstracting alert data from the ePRO database
Time frame: up to 48 hours
% of Patients Completing ≥1 ePRO Survey
ePRO surveys are abstracted from the electronic patient-reported outcome system
Time frame: up to 6 months
% of Expected ePRO Surveys Completed Per Patient
ePRO surveys are abstracter from the database; the surveys completed are compared to those sent
Time frame: up to 6 months
% of Surveys Completed of Surveys Sent to Patient
ePRO surveys are abstracted from the ePRO database including surveys completed
Time frame: up to 6 months
Symptom Trajectory
abstract from ePRO database the symptom alerts; we will report the proportion alerting for the population over 6 months
Time frame: up to 3 months; up to 6 months
Number of ED Visits
Proportion with patients with an ED visit (abstracted from the electronic medical record)
Time frame: up to 3 months, up to 6 months
Number of Hospitalizations
Proportion of patients hospitalized (abstracted from the EMR)
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Time frame: up to 3 months, up to 6 months
Number of ICU Visits
Proportion admitted to the ICU
Time frame: up to 3 months, up to 6 months
Total Cost of Care
total costs sent by UAB to payers (abstracted from billing records)
Time frame: up to 3 months, up to 6 months