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Electronic PRO Monitoring in Duke Oncology Clinics
World Cancer Congress Presentation
Bradford Hirsch, MD, MBA
August 28rd, 2012
Electronic PRO Monitoring in Duke Oncology Clinics World Cancer - - PowerPoint PPT Presentation
Electronic PRO Monitoring in Duke Oncology Clinics World Cancer - - PowerPoint PPT Presentation
Electronic PRO Monitoring in Duke Oncology Clinics World Cancer Congress Presentation Bradford Hirsch, MD, MBA August 28 rd , 2012 Medicine at Transition Point Medicine at Transition Point Care Redesign Patient Quality Centered Data
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Medicine at Transition Point
Data Driven Care
Care Redesign Quality Metrics CER
Personalized
Medicine Patient Centered Care
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Evidence Based Medicine: A Paradigm Shift
! Concerted international effort to close the gap between
research and practice (CER, PM…)
! Systematic collection, synthesis, and use of evidence to
guide decisions
! Potential to: ! Show which interventions are most effective and
efficient
! Choose among alternatives ! Identify knowledge gaps
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Paradigm Shift
Clinical Research Patient Care Basic Science
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Duke Center for Learning Health Care Experience
!
ePRO = prototype system for PRO collection & analysis
!
On-the-ground, real-time mechanism for CER, personalized medicine, care optimization, and quality improvement
!
Research demonstrates system is: ! Easy to use and navigate ! Valid and reliable ! Appropriate for clinical trials
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Collection Methods
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Validated Questionnaires Available
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Interface
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7 H
Research Clinical Operations & Quality Patient
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Output for clinicians
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Output for clinicians
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Utilization
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In Practice
!
Sexual Distress
!
>30% of breast, GI, and lung pts in mod-severe distress
!
Correlates to QOL, functional status, and symptoms
!
Clinicians not addressing the issue
!
Reorganized education and care " ACS funded RCT
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Sequentially Linked Data
ePRO
Clinical & administrative Clinical trial & research Molecular & biologic New datasets sequentially added, starting at the patient level, using warehousing or federated
- models. The key element is
patient-level linkage.
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Vision Patient reports standardized data Clinical uses
- Longitudinal reporting
at POC
- ROS & Decision making
- Patient education
- Triggered interventions
Research Uses
- Quality reporting
- CER
- Hypothesis generation
Clinical Decision Support & Guidelines
Patient
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Evolution
! Improve visualization ! Trigger interventions &
education
! Provide scorecards that include
PROs as a core component
! Enable rapid learning clinic ! Embed randomization
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Education
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Evolution
! Improve visualization ! Trigger interventions &
education
! Provide scorecards that include
PROs as a core component
! Enable rapid learning clinic ! Embed randomization
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