MyChristie-MyHealth: introducing electronic patient reported outcome measures (ePROMs) in routine practice to revolutionise cancer care

Abstract

Introduction: The integration of Patient Reported Outcome Measures (PROMs) in oncology improves survival and quality of life in clinical trials. Our organisation is, to our knowledge, the first cancer centre worldwide to introduce electronic PROMs (ePROMs) on a large scale as a standard service in clinical practice. Methods: We developed an ePROMs platform, ‘MyChristie-MyHealth’, where patients complete online questionnaires remotely. The questionnaires include Quality of Life (EQ-5D-5L) and symptombased questions, adapted from the Common Terminology Criteria for Adverse Events (v4.03) following clinician and patient feedback. Following questionnaire completion, patients receive advice on the management of their symptoms based on their responses (Fig. 1). Clinicians review the results through an online portal which is currently separate to the Trust’s electronic patient record. The service received local Information Governance Caldicott approval and clinical safety sign-off. Results: From January 2019, ‘MyChristie-MyHealth’ was rolled out to all patients with lung and head and neck cancer, as well as those treated with Proton Beam Therapy (≥16 years old). Patients received a text message or email containing a web link 3 days prior to their outpatient clinic appointment. Using the link, patients accessed ‘MyChristie-MyHealth’ and completed questionnaires remotely. Out of the 5062 questionnaires sent to lung cancer patients from January-September 2019, 1781 (35%) were completed. Completion rates remained overall stable since the initial roll out, reaching a maximum completion rate of 51% in May 2019. The main challenge is clinical team engagement due to the platform not being integrated into the Trust’s electronic patient record. Conclusion: The implementation of ePROMs in routine clinical practice is feasible. Future work will focus on integrating the platform to our electronic patient record, using ePROMs to personalise follow-up pathways and developing a real-time response platform with clinical staff contacting patients who report severe symptoms.