What question did this study set out to answer?

The aim was to implement an EHR-integrated Practical Geriatric Assessment (PGA) at a cancer center for older adults and evaluate its completion and documentation.

May 30, 2026

Implementing ASCO’s PGA at an NCI-designated comprehensive cancer center.

Key Points

The aim was to implement an EHR-integrated Practical Geriatric Assessment (PGA) at a cancer center for older adults and evaluate its completion and documentation.
Integrated a 19-question PGA into EHR during new patient check-in using tablets.
Eligible patients were those aged ≥65 years attending oncology visits.
Monitored initiation, completion, documentation uptake, and referrals during the pilot period.
Out of 236 eligible visits, the PGA was assigned in 224 cases (94.9%).
58.5% of patients signed in to use the tablet, with 86.3% of those completing the PGA.
PGA results were documented in 8.0% of encounters, with two referrals placed.

Abstract

e13764 Background: Randomized controlled trials demonstrate that geriatric assessments (GA) improve outcomes for older adults with cancer. ASCO recommends GA for patients aged ≥65 years prior to initiating therapy and endorses the Practical Geriatric Assessment (PGA) as a guideline concordant tool. However, cited barriers to implementation of GA include workflow burden, time constraints, and staffing limitations. Our objective was to implement an EHR-integrated PGA questionnaire embedded within routine oncology clinic visit intake at an NCI-designated Comprehensive Cancer Center and evaluate PGA completion and documentation. Methods: We integrated the questionnaire components of the PGA, consisting of 19 questions that address 7 health domains, into an EHR delivery platform and administered the questionnaire on a tablet during new-patient check-in. A programmed structured documentation template enables scored results to populate in the clinical encounter note with an embedded EHR-linked order set to facilitate concordant supportive care referrals. Eligible patients are aged ≥65 years seen for a new patient oncology visit. A rule-based algorithm identified new-patient encounters, triggering automatic assignment of the PGA at visit creation. Pre-specified implementation outcomes included PGA initiation and completion at check-in, provider documentation uptake via the structured documentation template, and referrals generated through the PGA-linked order set. The implementation pilot period is 11/19/2025-6/1/2026. Results were analyzed using descriptive statistics. Results: During the first two months of implementation, 236 new oncology patient visits were eligible for the PGA. The EHR-based algorithm successfully assigned the electronic PGA to 224 of 236 eligible visits (94.9%). Of these, 131 patients (58.5%) signed into a tablet at check-in, (surrogate marker for tablet receipt). Among patients who received a tablet, 113 of 131 (86.3%) answered PGA questions. Mean completion time was 9.35 minutes (SD 5.39). On average, 15.8 of the 19 questions were answered. PGA results were incorporated into provider documentation for 18 encounters (8.0%), representing six unique providers. Two referrals were placed via the PGA-linked order set. Conclusions: Early results suggest this EHR native approach offers a scalable framework for implementing guideline recommended GA. Additional stakeholder education is planned during this pilot to increase tablet receipt during check-in and physician review and use of data to support geriatric assessment guided management plans. Updated results will be presented at the annual meeting.

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