Increasing Symptom Recognition Using Electronic Patient-Reported Outcomes in an Oncology Research Clinic

The subjective nature of symptoms makes them challenging for providers to effectively assess. Implementing electronic patient-reported outcome (ePRO) surveys could improve symptom recognition and decrease emergency department (ED) visits and symptom severity while increasing psychosocial discussions. An oncology clinic's initial symptom assessment process focused on common oncological complaints, leading to unmet symptom management needs and resulting in approximately 23 monthly ED visits. Iterative Plan-Do-Study-Act cycles were used to guide this project. Patients completed ePRO surveys which allowed visits to be focused on self-identified severe symptoms. The average number of monthly ED visits declined from 23.25 to 19.5 (P = .10), and severe adverse events decreased from 0.27 to 0.25 (P = .95). Discussions concerning depression rose from 21% to 23.3% (P = .78). Implementing ePRO surveys was associated with a reduction in ED visits and an increase in psychosocial conversations, indicating that ePROs may contribute to improved value-based care.