Introduction
cancer, cancer symptoms, Cancer
CANCER, CANCER
Patient-reported outcome measures (PROMs) are increasingly used to better understand patients’ health, function, and experiences with healthcare. Research suggests that PROMs may improve symptom detection and treatment in patients with cancer [Electronic PROMs (ePROMs) may be a particularly appealing method for identifying cancer symptoms between clinic visits. The COVID-19 pandemic, which decreased the availability of in-person visits, bolstered the prevalence of telehealth but raised questions about how to make care equitable and accessible (e.g., for rural dwelling, impoverished, and older patients and those lacking technological access or knowledge), while ensuring high-quality remote assessment, including with the use of ePROMs [Assessments of implementation context during the pre-implementation phase can identify barriers and facilitators to be considered prior to implementing an intervention, which in turn can bolster implementation success and improve uptake among patients and clinicians [The present study explored pre-implementation barriers and facilitators to ePROM implementation in the context of initiating a stepped-wedge, cluster randomized pragmatic trial of a remote symptom management intervention, Enhanced EHR (electronic health record)-facilitated Cancer Symptom Control (E2C2) [Stepped-wedge trial design showing pre-implementation, usual care, and implementation phases