We aim to implement a structured symptom and health-related quality of life (HRQOL) reporting service and information technology (IT) solution, to translate into practice recent research findings (e.g. Basch et al 2017) for patients undergoing chemotherapy for colorectal cancer at three facilities in Metro North Hospital and Health Service (MNHHS).
A multidisciplinary steering committee is guiding development of the service and IT solution. No known existing solutions met our requirements. Few used validated symptom or HRQOL questionnaires. Identifiable, longitudinal symptom and HRQOL reports were often unavailable. Cost structures for scalable commercial solutions were prohibitive. Creation or revisions to questionnaires and software enhancements could not usually be self-managed.
An in-house IT solution was commissioned, despite increased risk. The Edmonton Symptom Assessment System (ESAS) and Patient Health Questionnaire (PHQ) 2-question version (PHQ-2) tools were selected for symptom reporting. We are trialling two HRQOL surveys (EQ-5D and European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and CR29 modules) to compare response rates. Work processes, including supporting patients to consent, register and use the solution, are under development.
New colorectal patients will be informed of the initiative at their first medical oncology consultation. Baseline symptom and HRQOL reports will be sought from consenting patients before chemotherapy commencement. Thereafter, fortnightly symptom and three-monthly HRQOL reports will be prompted. Patients and clinicians will have access to longitudinal reported data, which will guide treatment and augment identification of supportive and allied health needs.
A customised, in-house solution seems an achievable, economical and scalable approach to translating contemporary research about patient-reported information into practice. Collaboration between motivated, engaged clinicians and IT experts is pivotal, as is financial and philosophical commitment from the health service. Developing flexible IT and service infrastructure internally is expected to catalyse further innovation and efficiencies in this area.