Electronic Patient-Reported Outcomes Platform Successfully Implemented at Community Practice

By Leah Lawrence - January 26, 2023

A large community oncology practice was able to successfully implement an electronic patient-reported outcomes (ePRO)-based digital symptom monitoring platform, allowing patients to submit information about their distress and symptoms.

“Quality care for patients with cancer requires open lines of communication between patients and their care teams,” researchers wrote in JCO Oncology Practice. “Real-time patient reporting of issues and concerns and timely clinician responses are necessary to improve patient outcomes.”

Members of the Highlands Oncology Group recently reported on the implementation of an ePRO-based digital symptom monitoring platform. The cloud-based system allowed patients to “submit scheduled and unscheduled reports of their distress and specific symptoms using either a symptom reporting application, which can be used on a smartphone or tablet, or an interactive voice response (IVR) interface (telephone report).”

In about 17 months, 923 patients were successfully enrolled in the use of this program. Retention rates were high with 94% at 3 months, 88% at 6 months, 73% at 9 months, and 67% at 12 months, respectively. Retention was significantly higher at 12 months among patients older than 65 (P=.0011).

Of the ePRO reports submitted, which exceeded 25,000, about half (49%) were greater than the predefined alert thresholds and 8% included severe symptoms. Most patients also submitted 2 or more reports each month.

Members of the nursing team responded within 24 hours by telephone to about one-third (31.2%) of reports.

“Not all alerts generated a telephone call,” the researchers explained. “Clinical judgment was exercised by nurses during the evaluation of patient reports including all reports defined as severe.”

The most common alert-generating symptoms were high levels of distress, pain, nausea, weakness, diarrhea, dyspnea, and fatigue. Only 6.4% of reports required an office evaluation within 72 hours.

“This single-center experience supports the hypothesis that implementing an ePRO-based digital symptom monitoring platform is feasible in routine clinical practice at a large scale,” the researchers concluded. “We provide evidence that patients can remain engaged over a prolonged period of time with regular reporting and low attrition.”


Feasibility of large-scale implementation of an electronic patient-reported outcome remote monitoring system for patients on active treatment at a community cancer center.