Harmonization of patient-reported outcomes into EHRs at four cancer hospital outpatient clinics for patient care and quality assessment.
129 Background: Patient-reported outcome (PRO) measures are well established in oncology trials but are not collected systematically during clinical care, to guide symptom management, or to assess quality. A growing body of evidence shows that collecting PROs during cancer care yields better clinical outcomes. Yet, little is known about best practices for PRO integration into electronic health record (EHR) workflows. We report on the first cross-institutional effort for PRO data harmonization across four CTSA-funded institutions (University of North Carolina at Chapel Hill, Wake Forest University, Duke University, Medical University of South Carolina). Methods: Through surveys, systematic stakeholder qualitative focus groups, a landscape analysis, and technical/workflow assessment, our cross-institutional team sought to: 1) determine a set of common PRO measures to be collected via patient portals tethered to EHRs across the 4 sites; 2) develop an implementation strategy for the collection of PROs via patient portal within clinical workflows; and 3) collect a common set of PROs in cancer clinical care. We also sought to develop the methodological steps to harmonize extracted PRO data across each site to each other and then to the PCORnet Common Data Model Common Measures for PROs across each site. Results: Across the four sites, each institution uses Epic Systems (EHR and patient portal) and had available a library of PRO questionnaires which included the PROMIS profile (29 items) and short forms, SF-20, RAND, PHQ-2, and PHQ-9. The study team developed a list of domains and the tools available within each domain for stakeholders to prioritize at each site. The proposed workflows take into consideration the use of these data within the clinical encounter. Pilots at each site to collect PROs are underway along with the methodological work for data extraction and harmonization and will be reported at the meeting. Conclusions: The collection of a common set of PROs across EHRs has important implications for improving individual patient’s symptoms and for enhancing the quality of cancer care. Complex workflows and technical barriers must be considered successful implementation.
Chung, A; Stover, AM; Wagner, LI; LeBlanc, TW; Topalaglu, U; Zafar, Y; Zullig, LL; Smeltzer, P; Basch, EM
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