QOL-25. Clinician Perspectives on the Implementation of SyMon-SAYS: A Real-World Trial of Symptom Monitoring Through the Electronic Medical Record

OBJECTIVES SyMon-SAYS (Symptom Monitoring and Systematic Assessment and Reporting System in Young Survivors) is an EMR-integrated symptom monitoring program designed to collect real-world, patient-reported data between clinical visits to support timely symptom management in pediatric oncology. The system generates alerts when symptom scores exceed predefined thresholds, prompting clinicians for early intervention. Clinician engagement is critical to the success of such interventions, but their perspectives are often underexamined. This study evaluates clinician perceptions of the SyMon-SAYS program after a 16-week clinical trial. METHODS Pediatric cancer patients (ages 8–17) undergoing active treatment completed weekly symptom assessments of nine domains via the Epic EMR system. When symptom scores exceeded predefined thresholds, automated alerts were sent to clinicians. Symptom score reports were available in Epic for review by clinicians and patients/parents. At the trial’s conclusion, clinicians—including attending physicians, residents, fellows, and advanced practice nurses (APNs)—completed a 14-item evaluation survey to assess their perceptions of the system’s utility and impact. Mixed-effects linear regression models evaluated differences in responses between clinician types (MD/OD vs APNs). RESULTS Of 128 surveys sent to clinicians treating 97 participants, 80 surveys were completed by 37 clinicians (23 MD/ODs, 14 APNs). 84% of respondents reported that SyMon-SAYS did not add significant workload. However, responses varied, with APNs less favorable compared to MD/ODs, particularly regarding its benefits for children with cancer (2.12 vs. 1.38; p=0.03). APNs, but not MD/OD, expressed concerns about program efficiency and applicability in their workflow. CONCLUSIONS Most clinicians reported that SyMon-SAYS did not increase their workload, but perceptions varied by clinician role. These findings suggest that future symptom monitoring programs should be tailored to meet the needs of diverse healthcare providers to improve engagement and overall effectiveness.