Developing, implementing, and testing the effectiveness of systematic electronic symptom management systems in cancer care delivery
The symptom burden experienced by people with cancer is considerable. Patient-reported outcome (PRO) assessment of symptoms and functioning is increasingly used as a strategy to improve symptom management. However, there is limited evidence regarding the optimal approach and implementation of electronic PRO (ePRO) systems. When ePRO systems are well-integrated into the electronic health record (EHR), information can be accessed by clinicians with the potential to conveniently coordinate responses such as referrals and prescriptions. However, the adoption of ePRO systems is still in its infancy. Many ePRO systems do not interface seamlessly with the EHR, and do not offer evidence-based guidance, nor integrate appropriate responses into clinical workflows.
What we’re doing
Improving the Management of symptoms during And following Cancer Treatment (IMPACT) Consortium is an initiative funded by the Cancer MoonshotSM aimed at developing, implementing, and testing the effectiveness of systematic electronic symptom management systems in cancer care delivery.
The IMPACT Consortium includes three Research Centers (RCs) and a Coordinating Center. Each RC is conducting a large pragmatic clinical trial using ePROs to prompt clinician responses consistent with evidence-based guidelines. The trials use hybrid effectiveness-implementation designs and implementation science approaches to promote integration of research findings into policy and practice.
RTI International serves as the Coordinating Center and provides support for the RCs through the following activities:
- Fostering collaborations among participating investigators, patient advocates, and other stakeholders.
- Preparing policy and procedural manuals and governance plans,
- Overseeing data harmonization and development of a common data model.
- Developing analysis plans, performing pooled analyses, and synthesizing findings.
- Developing procedures to share data and disseminating findings.
- Providing subject matter expertise in informatics, clinical decision support, implementation science, and stepped wedge trial design.
The end products of this research will generate evidence about the multilevel barriers and facilitators to effective symptom management, as well as identify optimal implementation strategies to mitigate challenges. One manuscript underway describes the developing of the Longitudinal Implementation Strategy System (LISTS), a tool and method for longitudinal tracking of implementation strategies using the electronic data capture interface in REDCap.
- National Cancer Institute (NCI)