Utilizing Patient Reported Outcome Measures (PROMs) in ambulatory oncology in Alberta: Digital reporting at the micro, meso and macro level.
Utilizing Patient Reported Outcome Measures (PROMs) in ambulatory oncology in Alberta: Digital reporting at the micro, meso and macro level.
复制标题
DOI：
10.1186/s41687-021-00373-3
复制
发表时间：
2021-10-12
影响因子：
2.7
通讯作者：
Smith L
中科院分区：
文献类型：
--
作者：
Watson L;Delure A;Qi S;Link C;Chmielewski L;Photitai É;Smith L
癌症患者在患病过程中会经历许多令人痛苦的症状和担忧，这对他们的生活质量产生负面影响。无论癌症类型如何，未经控制的症状都可能导致下游不良后果。患者报告结果测量 (PROM) 可用于为患者护理提供信息并进行有针对性的症状管理，但仅收集此信息并不能改善患者的结果。如果要使用患者生成的信息来为门诊肿瘤设施中的护理提供提供信息，那么临床医生必须易于访问和解释这些信息。这项务实的工作回应了这一需求。加拿大的一个省级门诊肿瘤学管辖区在省级电子病历 (EMR) 中对 PROM 实施了数字化跟踪，以支持将 PROM 完全集成到标准护理工作流程和流程中。由于 EMR 中无法直接输入患者信息，因此设计了一种混合数据输入方式，患者在候诊室完成纸质 PROM，临床审查后，临床医生将其连同临床评估一起记录在 EMR 中。开发了多种数字仪表板，报告微观（个人）、中观（诊所）和宏观（项目）级别的 PROM 数据。在这些省级医疗机构中常规使用 PROM 有很多好处，包括加强患者与临床医生的沟通、协助发现问题、管理症状以及改善患者的治疗结果。我们的 PROM 数据库中有超过 60,000 名独特的患者，并捕获了超过 300,000 个独特的筛查事件。 PROM 数据现已在省级癌症管辖区的各级使用，以提供有针对性的以人为本的护理（微观）、为诊所或项目级别的适当人员（中观）以及省级项目的能力规划（宏观）。目前正在实施一个新的省级电子病历，其中有一个相关的患者门户。基于这项工作的成功，该辖区正在整合患者在预约前直接输入 PROM 以及相关的症状管理工作流程。
Cancer patients experience numerous distressing symptoms and concerns across the course of their illness, which negatively influence their quality of life. Regardless of cancer type, unmanaged symptoms can lead to adverse downstream consequences. Patient Reported Outcome Measures (PROMs) can be used to inform patient care and lead to targeted symptom management but simply gathering this information does not improve outcomes for the patient. Patient generated information must be easy for the clinicians to access and interpret if it is to be used to inform care delivery in ambulatory oncology facilities. This pragmatic work responded to this need. One Canadian provincial ambulatory oncology jurisdiction implemented digital tracking of PROMs over time in the provincial Electronic Medical Record (EMR) to support full integration of PROMs into standard care workflows and processes. Due to an inability within the EMR for direct patient entry, a hybrid data-entry was designed where the patient completes a paper-based PROM in the waiting room, and after clinical review, a clinician documents this along with their clinical assessment in the EMR. Several digital dashboards were developed which report PROMs data at the micro (individual), meso (clinic) and macro (program) levels. Using PROMs routinely in these provincial practice settings has numerous benefits including enhanced patient-clinician communication, assisting with problem detection, management of symptoms, and improving outcomes for patients. There are over 60,000 unique patients represented in our PROMs database, and over 300,000 unique screening events captured. The PROMs data is now used at all levels of the provincial cancer jurisdiction to provide targeted person centred care (micro), to staff appropriately at a clinic or program level (meso), and for capacity planning for provincial programs (macro). A new provincial EMR is currently being implemented which has an associated patient portal. Based on the success of this work, integration of direct entry of PROMs by the patient prior to the appointment and an associated workflow for symptom management is underway in this jurisdiction.
登录
查看更多内容
影响因子：
254.7
作者：
Hui, David;Hannon, Breffni L.;Bruera, Eduardo
通讯作者：
Bruera, Eduardo
影响因子：
39.2
作者：
Grant, Richard W.;Ashburner, Jeffrey M.;Atlas, Steve J.
通讯作者：
Atlas, Steve J.
DOI：
10.6004/jnccn.2016.0135
发表时间：
2016-10-01
影响因子：
13.4
作者：
Tamagawa, Rie;Groff, Shannon;Watson, Linda
通讯作者：
Watson, Linda
影响因子：
2.6
作者：
Cuthbert, C. A.;Watson, L.;Cheung, W. Y.
通讯作者：
Cheung, W. Y.
影响因子：
2
作者：
Yates, Patsy
通讯作者：
Yates, Patsy