Implementation and Feasibility of an Electronic Health Record-Integrated Patient-Reported Outcomes Symptom and Needs Monitoring Pilot in Ambulatory Oncology.
Implementation and Feasibility of an Electronic Health Record-Integrated Patient-Reported Outcomes Symptom and Needs Monitoring Pilot in Ambulatory Oncology.
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电子健康记录的实施和可行性-门诊肿瘤学中整合患者报告的结果、症状和需求监测试点。
DOI：
10.1200/op.21.00706
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发表时间：
2022-07
影响因子：
4
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描述门诊肿瘤学中不同种族/民族患者群体中电子健康记录(EHR)综合症状和需求筛查和转诊系统的可行性和实施情况。数据从2019年10月至2021年1月从迈阿密大学卫生系统的一家门诊肿瘤学诊所收集。在患者咨询委员会和探索、准备、实施和持续模式的指导下，My Wellness Check被开发用于在确定症状升高(例如抑郁)、护理障碍(例如交通和儿童护理)和营养需求时，在预约分流到支持服务之前评估动态肿瘤患者的身体和心理症状和需求。从第二次就诊开始，在30天的时间里，患者在每次预约时被分配的评估不超过一次。评估以英语和西班牙语提供，以满足主要讲西班牙语的拉美裔/拉丁裔人口的需要。在1232项指定评估中，超过一半(n=739项评估；60.0%)是由506名独立患者发起的。共有65.4%的英语和49.9%的西班牙语评估是启动的。在所有发起的评估中，大多数(85.1%)是在家中通过患者门户完成的。最常见的认可项目是营养需要(32.9%)，其次是情绪症状(即抑郁和焦虑；27.8%)、实际需要(例如，经济问题；21.7%)和身体症状(17.6%)。在与身体症状、社会工作和营养相关的警报中，77.1%、99.7%和78.8%分别由相应的肿瘤学健康专业人员、社会工作团队成员或营养师处理。结果表明，在不同的肿瘤科患者中实施EHR综合症状和需求筛查和转诊系统的可行性和初步可接受性令人鼓舞。据我们所知，这是第一个在西班牙语拉美裔/拉美裔常规肿瘤学护理中实施的EHR综合症状和需求筛查系统。
Describe the feasibility and implementation of an electronic health record (EHR)–integrated symptom and needs screening and referral system in a diverse racial/ethnic patient population in ambulatory oncology. Data were collected from an ambulatory oncology clinic at the University of Miami Health System from October 2019 to January 2021. Guided by a Patient Advisory Board and the Exploration, Preparation, Implementation, and Sustainment model, My Wellness Check was developed to assess physical and psychologic symptoms and needs of ambulatory oncology patients before appointments to triage them to supportive services when elevated symptoms (eg, depression), barriers to care (eg, transportation and childcare), and nutritional needs were identified. Patients were assigned assessments at each appointment no more than once in a 30-day period starting at the second visit. Assessments were available in English and Spanish to serve the needs of the predominantly Spanish-speaking Hispanic/Latino population. From 1,232 assigned assessments, more than half (n = 739 assessments; 60.0%) were initiated by 506 unique patients. A total of 65.4% of English and 49.9% of Spanish assessments were initiated. Among all initiated assessments, the majority (85.1%) were completed at home via the patient portal. The most common endorsed items were nutritional needs (32.9%), followed by emotional symptoms (ie, depression and anxiety; 27.8%), practical needs (eg, financial concerns; 21.7%), and physical symptoms (17.6%). Across the physical symptom, social work, and nutrition-related alerts, 77.1%, 99.7%, and 78.8%, were addressed, respectively, by the corresponding oncology health professional, social work team member, or nutritionist. The results demonstrate encouraging feasibility and initial acceptability of implementing an EHR-integrated symptom and needs screening and referral system among diverse oncology patients. To our knowledge, this is the first EHR-integrated symptom and needs screening system implemented in routine oncology care for Spanish-speaking Hispanics/Latinos.