PATIENT REPORTED OUTCOMES AT THE ABRAMSON CANCER CENTER Amy Lanza Mentor: Carmen Guerra, MD, MSCE
WHAT ARE PATIENT REPORTED OUTCOMES? Patient reported outcomes, or PROs, allow the clinician or health-care provider to gain insight into the way patients perceive their health Self-reported Most often in form of questionnaire in clinical setting Image: http://commonfund.nih.gov/promis/
BENEFITS OF PRO COLLECTION Source: Academy Health Conference 2012 Image: http://www.clker.com Enhances patientprovider communication Improved care Personalized Evidence-based Outside realm of traditional medical care Facilitate clinical research
BARRIERS TO PRO COLLECTION Burdensome for provider Increased staff burden Disrupted clinic flow Budget concerns Burdensome for patient Language barriers Competing priorities in clinical care Source: Hostetter 2012 Image: http://travelgoat.tumblr.com
POSITIVELY IMPACT OUTPATIENT CLINICAL CARE? Clinically relevant Easy to interpret Easy to integrate into clinical work flow Relevant to research in improving patient care Source: Academy Health Conference 2012
OBTAINING PROS WITH E-TABLETS Promotes patient activation Increases doctor-patient dialogue When compared to paper collection: Cheaper over time Preferable by patients Eliminates additional data entry Has least impact on clinic flow Patients more comfortable with self-reporting Barriers? Source: Abernathy, et al. 2008
WHY IS THIS SIGNIFICANT? Measurement of PROs has increasingly gained support and acceptance as important and valid measures of symptoms, experiences, healthrelated quality of life and cancer treatment toxicity Many organizations are now requiring measurement of PROs as an important metric for evaluating value of health care services to patients Specifically, the Committee on Cancer will require that all accredited cancer centers measure PROs by 2015
SPECIFIC AIMS Design methods for electronic administration of PRO questionnaires using e-tablet technology with software that is interoperable with Epic Electronic Health Records Evaluate the feasibility and patient acceptability of using tablet personal computers to collect PROs OUR HYPOTHESIS: E-Tablet technology will be an acceptable platform to administer patient questionnaires.
METHODS
PROJECT POPULATION Key inclusion criteria: Patient is receiving care at the Abramson Cancer Center Patient has an established diagnosis of cancer Key exclusion criteria: Patient is unable to give informed consent Patient has previously participated in the current study Image: http://www.asbestos.com
STUDY DESIGN Plan to enroll 100 participants 12-month study Abramson Cancer Center Projected duration of participation for each subject = 30 minutes
METHODS Cross-sectional questionnaire Participants will be given choice of: Filling out a questionnaire on an e-tablet before their appointment at oncology clinic Filling out questionnaire on patient s personal computer through EPIC MyPenn Medicine prior to coming to appointment
STUDY QUESTIONNAIRES Generalized Anxiety Disorder 7-item (GAD-7) scale Patient anxiety Patient Health Questionnaire (PHQ-9) Patient depression An e-tablet feasibility and acceptability questionnaire 8 th grade reading level Patients perceived ease (feasibility) and satisfaction of use (acceptability) of e-tablet How e-tablet may change patients behavior Demographic information
EXAMPLE OF E-TABLET QUESTION:
NEXT STEPS Pilot questionnaires Use PRO data to improve patient quality of care Investigate ways to further increase patient feasibility and acceptability of collecting PROs, via e-tablet or other means of collection
Role in Project Designing a reliable questionnaire Drafting an IRB Proposal Lessons learned More informed about Patient Reported Outcomes How to design a questionnaire Completing an IRB Proposal Public health research in general
THANK YOU! Dr. Carmen Guerra Dr. Joseph Carver Sarah McCann
QUESTIONS/COMMENTS?