[ePROs in the routine care of a major oncology center: Results and experiences]

Abstract

Background: To what extent and under what conditions electronically captured patient-reported outcomes (ePROs) can be used in routine medical care and contribute to improved patient care is a widely discussed question. In the field of oncology, few studies in Germany have focused this topic that go beyond the scope of time-limited studies.

Method: First, we present the centrally coordinated collection of ePROs in the routine care of a comprehensive cancer center of the German Cancer Aid in its development, and then describe its qualitative dimension. Subsequently, the intervention is discussed using the Consolidated Framework of Implementation Research.

Results: Since the implementation started in 2019, over 2,000 patients from the interdisciplinary outpatient clinic of the oncology center have been surveyed. The number of respondents varied between 19 and 65 per month. Over the five years of the reporting period, numerous adjustments have been made regarding content and usage purposes as well as technical and personnel structures. The consistent purpose of use was screening for supportive needs, initially related to psycho-oncology, later expanded to include sports therapy, smoking cessation programs, social and nutritional counseling. The instruments used varied accordingly; health-related quality of life and psychological stress were consistently surveyed.

Discussion: Successful use of ePROs in oncological routine care requires personnel and technical resources as well as a high degree of adaptability. In our case, the complexity of a centrally coordinated ePRO collection within an interdisciplinary cancer center is of particular importance. Path dependencies arising from initial decisions, such as the survey software, need to be considered during implementation. Reservations about the intervention and the importance of opinion leaders for successful deployment have been observed. External conditions such as the certification system of oncology centers in Germany proved to be another relevant factor.

Conclusion: Overall, the analysis examines a segment of the ongoing digitization process of the hospital system directed towards needs-based, individualized patient care.

Keywords: CFIR; Implementation research; Implementierungsforschung; Oncology; Onkologie; PRO; PROM; Patient-reported outcomes; Patientenberichtete Angaben; Routine care; Routineversorgung.