Live Virtual Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Implementations of PROMS: Achieving system efficiencies (#45)

Bena Brown 1 2 , Laurelie Wishart 2 3
  1. Division of Cancer Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
  2. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
  3. Centre for Functioning and Health Research, Metro South Health Service, Brisbane, QLD, Australia

Patient-reported outcome measures (PROMs) in cancer care have been shown to improve communication, patient satisfaction and clinician-awareness of patient concerns, however the evidence that routine use of PROMs results in change to the patient-clinician interaction is lacking. Since 2016, an electronic PROM (My Health My Way, previously ScreenIT) has been implemented as standard care in patients with head and neck cancer at the Princess Alexandra Hospital, Brisbane. This model involves ePROM data capture through the My Health My way tool prior to routine¬†multidisciplinary team appointments, with allied health and nursing referrals generated and/or appointment scheduling escalated, modified or cancelled, based on validated risk triage algorithms and workflows. In 2020, this model of care has been expanded to Sunshine Coast University Hospital, Ipswich Hospital, and Cairns Base Hospital ‚Äď with each site providing differences in service provision (including variation in geographical location, on-treat vs. post-treatment services, public vs. private services, degree of allied health MDT involvement) and thus unique challenges for implementation.

Through the implementation process, a number of system efficiencies have been realised across the various sites. These are related to administrative planning, workforce planning and service delivery, face-to-face clinical interactions, documentation, reporting, and follow-up. Between 80-85% of patients adhere to completing ePROMs during their cancer care, resulting in 25% cancellation of unnecessary appointments, and cost-efficiencies of $1700 per patient. The system challenges of multi-site ePROM implementation relate to the variations in care, disciplines involved, and willingness to modify health care culture.