Skip to main content
SpringerLink
Log in

Collection of electronic patient-reported symptoms in patients with advanced cancer using Epic MyChart surveys

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Background

Use of electronic patient-reported outcomes (ePROs) in routine cancer care can help identify troublesome symptoms and facilitate discussions between patients and clinicians and has been shown to improve patient satisfaction, quality of life, and survival.

Methods

Eighty patients with stage IV non-hematologic malignancies on chemotherapy participated. Patient-Reported Symptom Monitoring (PRSM) surveys were sent every 14 days via the Epic MyChart system over a 12-week period. Surveys were offered via phone or paper if patients failed to complete the automated MyChart survey by day 16. Severe symptoms or concerning symptom trends were automatically highlighted in reports for clinic staff. Patients reporting severe symptoms were routed to oncology nursing triage for standard symptom care management.

Results

Two hundred seventy-one surveys were sent during the 12-week study period. One hundred eighty-three surveys (66%) were completed, with 68% completed electronically via MyChart, 25% by paper, and 7% by phone call from a research coordinator. At least one severe symptom was reported on 36% of all surveys. However, most severe symptoms did not result in urgent triage follow-up because they were already being addressed and/or patients felt they were manageable. Patients and clinicians generally said the ePRO was efficient and helpful for addressing distressing symptoms and would use it in routine oncology care.

Conclusion

ePROs can be integrated into the electronic health record using the Epic MyChart system. Patients and clinicians gave positive feedback on the system. Monitoring symptoms in real time may soon become part of standard oncology practice and requires seamless methods for collection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Von Roenn JH, Temel J (2011) The integration of palliative care and oncology: the evidence. Oncology (Williston Park) 25(13):1258–1260 1262, 1264–5

    Google Scholar 

  2. Halabi S, Vogelzang NJ, Kornblith A (2008) Pain predicts overall survival in men with metastatic castration-refractory prostate cancer. J Clin Oncol 26(15):2544–2549

    Article  Google Scholar 

  3. Quinten C, Coens C, Mauer M (2009) Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncol 10:865–871

    Article  Google Scholar 

  4. Basch E, Deal AM, Dueck AC (2017) Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA 318(2):197–198

    Article  Google Scholar 

  5. Laugsand EA, Sprangers MA, Bjordal K (2010) Health care providers underestimate symptom intensities of cancer patients: a multicenter European study. Health Qual Life Outcomes 8:104

    Article  Google Scholar 

  6. Basch E, Jia X, Heller G (2009) Adverse symptom event reporting by patients vs clinicians: relationships with clinical outcomes. J Natl Cancer Inst 101(23):1624–1632

    Article  Google Scholar 

  7. Stover A et al (2015) Integrating patient-reported outcome measures into routine cancer care: cancer patients’ and clinicians’ perceptions of acceptability and value. EGEMS (Wash DC) 3(1):1169

    Google Scholar 

  8. Cleeland C, Wang X, Shi Q (2011) Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. J Clin Oncol 29(8):994–1000

    Article  Google Scholar 

  9. Basch E (2014) The rationale for collecting patient-reported symptoms during routine chemotherapy. Am Soc Clin Oncol Educ Book:161–165

  10. Bennett AV, Jensen RE, Basch E (2012) Electronic patient-reported outcome systems in oncology clinical practice. CA Cancer J Clin 62(5):337–347

    Article  Google Scholar 

  11. Kotronoulas G, Kearney N, Maguire R (2014) What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials. J Clin Oncol 32(14):1480–1501

    Article  Google Scholar 

  12. Berry DL, Blumenstein BA, Halpenny B (2011) Enhancing patient-provider communication with the electronic self-report assessment for cancer: a randomized trial. J Clin Oncol 29(8):1029–1035

    Article  Google Scholar 

  13. Basch E, Abernethy AP (2011) Supporting clinical practice decisions with real-time patient-reported outcomes. J Clin Oncol 29(8):954–956

    Article  Google Scholar 

  14. Wagner LI, Schink J, Bass M (2015) Bringing PROMIS to practice: brief and precise symptom screening in ambulatory cancer center. Cancer 121(6):927–934

    Article  Google Scholar 

  15. Basch E, Barbera L, Kerrigan CL (2018) Implementation of patient-reported outcomes in routine medical care. Am Soc Clin Oncol Book 38:122–134

    Article  Google Scholar 

  16. Basch E, Abernethy AP, Mullins CD, Reeve BB, Smith ML, Coons SJ, Sloan J, Wenzel K, Chauhan C, Eppard W, Frank ES, Lipscomb J, Raymond SA, Spencer M, Tunis S (2012) Recommendations for incorporating patient-reported outcomes into clinical comparative effectiveness research in adult oncology. J Clin Oncol 30(34):4249–4255

    Article  Google Scholar 

  17. Jensen RE et al (2014) Review of electronic patient-reported outcomes systems used in cancer clinical care. J Oncol Pract 10(4):e215–e222

    Article  Google Scholar 

  18. Basch E, Deal AM, Kris MG (2016) Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol 34:557–565

    Article  CAS  Google Scholar 

  19. Shapiro CL (2018) Cancer survivorship. N Engl J Med 379(25):2438–2450

    Article  Google Scholar 

  20. Gilmer TP, O’Connor PJ, Sperl-Hillen JM (2012) Cost-effectiveness of an electronic medical record based clinical decision support system. Health Serv Res 47(6):2137–2158

    Article  Google Scholar 

  21. O’Connor PJ, Sperl-Hillen JM, Rush WA, Johnson PE, Amundson GH, Asche SE, Ekstrom HL, Gilmer TP (2011) Impact of electronic health record clinical decision support on diabetes care: a randomized trial. Ann Fam Med 9(1):12–21

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Jan Morgan for the help with study coordination, Mary VanBeusekom for the review of the manuscript, and Min Xi for the help with initial data analysis.

Funding

This study was financially supported by a Program Development Grant from Health Partners Institute

Author information

Authors and Affiliations

  1. Park Nicollet Oncology Research, Frauenshuh Cancer Center, HealthPartners Institute, Frauenshuh Cancer Center, 3800 Park Nicollet Blvd, Minneapolis, MN, 55416, USA

    Dylan M. Zylla, Grace E. Gilmore, Grant L. Steele, Justin P. Eklund, Christina M. Wood & Alice C. Shapiro

  2. Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Angela M. Stover

  3. Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA

    Angela M. Stover

Authors
  1. Dylan M. Zylla
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Grace E. Gilmore
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Grant L. Steele
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Justin P. Eklund
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christina M. Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Angela M. Stover
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alice C. Shapiro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dylan M. Zylla.

Ethics declarations

The study was approved by the Institutional Review Board at Health Partners Institute. Informed consent was obtained from all individual participants included in the study

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zylla, D.M., Gilmore, G.E., Steele, G.L. et al. Collection of electronic patient-reported symptoms in patients with advanced cancer using Epic MyChart surveys. Support Care Cancer 28, 3153–3163 (2020). https://doi.org/10.1007/s00520-019-05109-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-019-05109-0

Keywords

Search

Navigation