Development of an ePRO-oriented workflow and clinical roles
tumor, DSD
TUMOR, EVENT
In the eCCM, delivery system design (DSD) relates to how care is coordinated and delivered across the network of health resources. The participating oncology departments treat a similar range of tumor types and number of patients, with similar provider team compositions. Physicians and nurses involved in direct patient care revealed service-level and provider-level barriers such as the time required to navigate, collect, and process PRO data, the integration or lack thereof within the EHR, and internal communication pathways to ensure the continuity of care [We hereafter describe how patients are engaged, the triage process and the triage nurse role, and the nurse-physician coordination to provide care. An overview of the model is featured in Fig. Overview of the IePRO model of care: patients perform self-assessment (1) and declare potential symptoms using the symptom ePROM in the electronic application (2). Telephone triage nurses review PRO data and coordinate with the oncology team preemptively when necessary (3) and contact patients by telephone using a standardized triage process (4)Components of the eCCM in the IePRO model of careThe electronic mobile application containing the ePROM:• Communicates patient-reported data in real time• Engages patients with automated reminders to encourage self-assessment of symptoms• Provides patients with a chart portraying the evolution of their symptoms over time• Triage nurses call patients in the event of a new or worsening symptom and administer self-care and self-management support via telephone call.• Symptoms are relayed to the oncology care team via e-mail or telephone call, according to UKONS 24-hour triage tool recommendations.• The triage process is documented in the patient’s EHR.• Follow-up measures put in place are communicated with the broader team using e-mail.