Service evaluation of MyChristie-MyHealth, an electronic patient reported outcome measure integrated into clinical cancer care

Abstract

Introduction: Electronic Patient-Reported Outcome Measures (ePROMs) are multidimensional, digitalised health questionnaires sent to patients in order to assess their subjective experience of health and disease. They are becoming particularly prevalent in cancer care, where patients may experience wide-ranging symptoms and side-effects. MyChristie-MyHealth is the ePROM established into routine care at the Christie NHS Foundation Trust in 2019. We conducted an evaluation of this service in order to identify key barriers to its use, and also potential strategies for improvement. Methods: Data collection: Patients who had opted out of completing ePROMs (n=87) and who had completed at least one ePROM (n=87) were identified. Collected data included age, occupation, diagnosis and treatment intent. Semi-structured Interviews: Held with Non-completers (n=30) and Completers (n=31) of ePROMs, as well as clinician users (n=6). Questions covered themes such as accessibility, acceptability and usefulness, and ways in which the service could be improved. Results: Non-completers of ePROMs were older (median age 72 vs 66 years, p=0.005), had a history of unemployment or manual type work (86% vs 58%, p=0.003), on treatment with curative intent (OR 1.448, p=0.045) and less likely to be in a clinical trial (OR 0.531, p=0.011) (see Fig. 1). They shared some common misconceptions, such as that the invite link may have been a scam, and had reluctance with technology, but willing to complete ePROMs via email rather than Smartphone. Completers of ePROMs wanted their results to be acknowledged by their clinicians, and thought that inclusion of white-space response boxes would be an improvement. Clinicians wanted ePROM results to be displayed in a more user-friendly way Conclusions: We have broadly characterised non-completers of ePROMs in order to identify those in need of extra support or encouragement in the clinic. An action plan resulting from this review will inform the future development of MyChristie-MyHealth.