Implementation of electronic patient reported outcomes and impact on communication with patients

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Project Abstract This application is submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-23-041. “Implementation of Electronic Patient Reported Outcomes and Impact on Communication with Patients” leverages a unique opportunity (1) to evaluate sustainability of the use of an existing electronic symptom management platform (eSym), and (2) to evaluate the impact of eSyM reporting on patient-clinician communications. Since eSyM was recently developed and implemented at the Dartmouth Cancer Center (DCC) for patients with gastrointestinal, thoracic, and gynecologic cancers, there is a critical need to rapidly assess the sustainability of this digital platform beyond a six-site federally-funded type II hybrid effectiveness- implementation cluster randomized trial (UM1 CA23080-01; NCT03850912), guided by RE-AIM and the Dynamic Sustainability Framework. Further, we will also be able to assess tradeoffs between increasing utilization of digital tools and potential for unintended consequences of a decrease in the quality of direct patient-clinician communications as well as widening of the so-called digital divide in rural and aging populations. Alternatively, collection of electronic patient reported outcomes as part of the eSyM platform may enhance communication and patient-clinician partnerships in care delivery and coordination for patients with a hematologic malignancy. This administrative supplement aligns with the NOSI by examining the effects of digital tools on patient-clinician communications and supports the goals of DCC in addressing improved patient outcomes through research in advancing patient-clinician communication, especially in underserved rural populations.