PROTEUS — PRACTICE
Oncology Pharmacist-Facilitated PROM Monitoring in UNC Cancer Clinics
University of North Carolina, Angela Stover and Debbie Liang (Multiple Principal Investigators)
Here you can learn more about the “Oncology Pharmacist-Facilitated PROM Monitoring in UNC Cancer Clinics,” which is part of the PROTEUS Learning Health Network. The Learning Health Network is focused on improving the use of patient-reported outcomes (PROs) in oncology clinical practice. Also, you can read about the valuable insights that have emerged from their participation in the Learning Health Network.
Debbie Liang, PharmD
Angela Stover, PhD
Project Overview
We developed and implemented a PROM monitoring system for pharmacists to manage side effects of oral oncolytics (chemotherapy taken by mouth). The PROM system is an electronic health record (EHR) SmartForm© in Epic where specialty pharmacists providing direct cancer care verbally ask the patient the side effect questions during routine telehealth encounters and enter responses in real time.
We chose verbal administration rather than electronic/online because our work has shown disparities in the patients who complete electronic/online PROMs, and our preliminary results suggest that implementing a verbal approach may address these digital disparities. We engaged multiple key partner groups including pharmacists who provide direct cancer care, pharmacy leadership, patients, advocates, MD and PhD champions, and Epic and pharmacy analytics for EHR programming to develop the SmartForm©.
Our findings will be useful to other healthcare systems looking for a PROM solution integrated in the EHR, with a reasonable pharmacist/clinician workload, and no requirement for patients to have internet access/comfort.
Learning Health Network Experience
We have appreciated the opportunity to meet monthly with other health systems implementing PROMs in Epic. We were particularly grateful for members of the Learning Health Network that provided ideas on how to overcome programming barriers in Epic.
We adopted PROTEUS’ use of the Knowledge to Action framework (Graham et al. 2004) to conceptualize the steps we took to develop the EHR SmartForm©. This paper is published in Quality of Life Research.