Background: Routine assessment and clinical utilisation of patient-reported outcome (PRO) measures can lead to improved patient wellbeing and survival outcomes. However, widespread collection and integration into clinical practice remains a challenge.
Methods: We developed PROMPT-Care, the first eHealth system which has been fully integrated into the hospital oncology information system, with clinical (n=38) and technical (n=23) input from across NSW. The system facilitates systematic real-time PRO collection and review by cancer care teams; and empower patients by providing self-management tools and resources tailored to their needs.
Results: We demonstrated feasibility and acceptability of PROMPT-Care in a pilot test (Phase 1), and are in the final stages of an implementation trial (Phase 2) across four cancer centres (400+ patients) to inform PROMPT-Care impact on health service utilisation and utility as an alternative model of ongoing supportive care. Given the high level of acceptability within participating sites and support from the South Western Sydney Local Health District [in 2017, PROMPT-Care won the Translational Research Award and the Board Award for the program most likely to influence patient care], we are working towards implementation as business as usual (Phase 3). However, the success of PROMPT-Care notwithstanding, the current system does not reach specific groups including those of non-English speaking backgrounds, who comprise a very significant sector of the Australian patient population, those with insufficient literacy to engage with the online questionnaires, and those without internet access. Strategies to extend the reach of PROMPT-Care are in development, including developing an App to overcome language, literacy and internet accessibility barriers.
Conclusion: Transitioning eHealth programs like PROMPT-Care from a funded research environment to business as usual, which is largely unfunded, is challenging. Significant planning and adequate resourcing is necessary to support implementation of evidence into real world clinical practice.
Funding: Cancer Institute NSW, Bupa Health Foundation