Implementation and evaluation of an expanded electronic health record-integrated bilingual electronic symptom management program across a multi-site Comprehensive Cancer Center: The NU IMPACT protocol

• DOI: 10.1016/j.cct.2023.107171
• Publication Date: 2023-03-28T15:57:02Z
• Authors: David Cella; Sofia F. Garcia; September Cahue; Justin D. Smith; Betina Yanez; Denise Scholtens; Nicola Lancki; Michael Bass; Sheetal Kircher; Ann Marie Flores; Roxanne E. Jensen; Ashley Wilder Smith; Frank J. Penedo
• Keywords: Adult; Neoplasms; Quality of Life; Humans; Electronic Health Records; Prospective Studies; Electronics; Delivery of Health Care; 3. Good health; Randomized Controlled Trials as Topic

People with cancer experience symptoms that adversely affect quality of life. Despite existing interventions and clinical guidelines, timely symptom management remains uneven in oncology care. We describe a study to implement evaluate an electronic health record (EHR)-integrated monitoring program adult outpatient Our patient-reported outcomes (cPRO) is customized EHR-integrated installation. will cPRO across all Northwestern Memorial HealthCare (NMHC) hematology/oncology clinics. conduct cluster randomized modified stepped-wedge trial patient clinician engagement cPRO. Further, we embed patient-level the impact additional enhanced care (EC; plus web-based self-management intervention) relative usual (UC; alone). The project uses Type 2 hybrid effectiveness-implementation approach. intervention be implemented seven regional clusters within healthcare system comprising 32 clinic sites. A 6-month prospective pre-implementation enrollment period followed by post-implementation period, during which newly enrolled, consenting patients randomly assigned (1:1) EC or UC. follow for 12 months post-enrollment. Patients receive evidence-based symptom-management content on cancer-related concerns approaches enhance life, using tool ("MyNM Care Corner"). This design allows within- between-site evaluation implementation group-based comparison demonstrate effectiveness outcomes. has potential guide future system-level programs. http://ClinicalTrials.gov # NCT03988543