Implementation of an electronic patient reported outcome system in a prostate cancer urology clinic

• Published in: Journal of clinical oncology Vol. 36; no. 7_suppl; p. 143
• Main Authors: Spillane, Maria, Pollock, Phil, Hedden, Lindsay, Wu, Eugenia, Goldenberg, Larry, Jones, Jennifer M., Matthew, Andrew, Truong, Tran, Gavrylyuk, Yuliya, Higano, Celestia S.
• Format: Journal Article
• Language: English
• Published: 01.03.2018
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2018.36.7_suppl.143

Abstract only 143 Background: The Prostate Clinic at Vancouver General Hospital recently implemented electronic Patient Reported Outcomes (ePRO) collection from prostate cancer patients (pts). The ePRO system was adopted from the University Health Network, Toronto. Our objective was to review the successes and challenges related to the implementation of the system during its first 6 months of use. Methods: All newly diagnosed pts, those going for a prostate biopsy, and pts booking surgery are asked to complete ePRO on iPads at their clinic appointment. The ePRO includes the EPIC-26, EQ-5D-5L, WHODAS 2.0 questionnaires and the Distress Thermometer. It takes about 4-5 minutes to complete the questions, and consent to be contacted about future prostate cancer research is also requested. Afterwards, pts complete ePROs at each clinic appointment. They receive a report summarizing that day’s responses in the context of previous responses. Results: Between 4-1-17 and 10-16-17, 360 pts were eligible to complete the ePRO. 311/360 pts (86.4%) filled out the ePRO at least once. Of the 49 who didn’t, 24 were missed by the coordinator and 21 were not referred by clinic staff. Only 4 pts (8.2%) refused to answer the ePRO. 18 of the 311 pts only partially answered the ePRO, most often due to the length of the questionnaires. 396 instances of ePRO were completed by 311 pts. WiFi connectivity issues were encountered 30/396 times, which prolonged ePRO completion time, and on 3 occasions resulted in patients refusing to complete ePRO. Conclusions: Implementation of the ePRO system into our urology clinic is a success based on a high completion and low refusal rate, and was organized mainly by a single individual. Challenges include training clinic staff to refer pts to complete ePROs at appropriate times, technical difficulties with WiFi connectivity, and the need to interact with each pt individually, which can be time consuming and result in lost data. Eventually, all pts will be trained to pick up an iPad and complete ePROs prior to each appointment. We found the system straightforward to use, and have updated our iPads with additional questionnaires. It is clear that systems collecting ePROs will become standard practice as technology improves and costs go down.