ABSTRACT Introduction: Electronic patient-reported outcome measures (ePROMs) have a robust evidence base showing that when they are routinely collected and actioned in clinical settings, they enhance patient-centered care and clinical decision-making. However, their integration into routine oncology care has often been hindered due to system and individual-level resistance as well as barriers to implementation, warranting a targeted change management approach. This case study presents the statewide change management approach to the implementation of an electronic patient-reported measures (ePRM) system in New South Wales (NSW), Australia. Methods: This study describes the process of statewide change management, guided by the ADKAR (Awareness, Desire, Knowledge, Ability, Reinforcement) change management model to support adoption and sustainability. A retrospective case study methodology is used. Change management strategies employed during the implementation of the ePRM system across NSW cancer services were elicited through stakeholder interviews and meetings with the change management team. Each phase of the ADKAR framework was mapped to implementation activities, stakeholder engagement efforts, and system refinements. Identified barriers were coded using the Consolidated Framework for Implementation Research (CFIR), and corresponding mitigation strategies were aligned with the Expert Recommendations for Implementing Change (ERIC) taxonomy. Results: The structured application of the ADKAR model enabled the change management team to anticipate and address a range of barriers. Strategies included tailored stakeholder engagement to build awareness and desire, role-specific training to develop knowledge, site-based troubleshooting and workflow adaptation to support ability, and performance monitoring to reinforce long-term use. Barriers such as perceived redundancy and time constraints were effectively mitigated through context-specific strategies mapped to relevant CFIR and ERIC constructs. The resulting implementation checklist provides a practical guide for organizations undertaking similar digital health transformations. Conclusions: Structured change management enabled the successful implementation of a digital health innovation—the ePRM system—at scale. By combining proactive planning, iterative design, and embedded support, digital health interventions can achieve sustained adoption. These findings offer actionable guidance for policymakers and health care leaders seeking to embed digital tools such as ePROMs into routine clinical care. Spanish abstract: http://links.lww.com/IJEBH/A493
Mazariego et al. (Mon,) studied this question.