Author:
Stan Daniela L.,Inselman Jonathan W.,Ridgeway Jennifer L.,Johnson Kaley N.,Christopherson Laura A.,McColley Samantha M.,Brown Julie K.,Phillips Sarah A.,Allen Summer V.,Hazelton Jennifer K.,Ruddy Kathryn J.,Haddad Tufia C.
Abstract
Abstract
Purpose
To assess the feasibility of an app-based, electronic health record (EHR)-integrated, interactive care plan (ICP) for breast cancer (BC) survivors.
Methods
A single-arm pilot study was conducted with female BC survivors. ICP tasks included quarterly quality of life (QOL) questionnaire; monthly assessments of fatigue, insomnia, sexual dysfunction, hot flashes, and recurrence symptoms; and daily activity reminders. Embedded decision trees escalated recurrence symptoms to providers. On-demand education was available for self-management of treatment-related toxicities. The primary objective was to assess patients’ engagement with ICP tasks against feasibility thresholds of 75% completion rate. Secondary objectives were evaluation of the system’s functionality to track and escalate symptoms appropriately, and care team impact measured by volume of escalation messages generated. We report preliminary results 6 months after the last patient enrolled.
Results
Twenty-three patients enrolled August to November 2020. Mean age was 50.1 years. All patients engaged with at least one ICP task. The monthly average task completion rates were 62% for the QOL questionnaire, 59% for symptom assessments, and 37% for activity reminders. Task completion rate decreased over time. Eleven of 253 symptoms and QOL questionnaires (4.3%) generated messages for care escalation.
Conclusion
Implementation of an app-based, EHR-integrated ICP in BC survivors was feasible and created minimal provider burden; however, patient engagement was below the feasibility threshold suggesting that changes may enhance broad implementation and adoption.
Implications for Cancer Survivors
An ICP may facilitate remote monitoring, symptom control, and recurrence surveillance for cancer survivors as strategies to enhance patient engagement are applied.
Funder
Mayo Clinic Department of Family Practice
Mayo Clinic Center for Digital Health
Publisher
Springer Science and Business Media LLC
Subject
Oncology (nursing),Oncology
Cited by
12 articles.
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