Involving the patient: a prospective study on use, appreciation and effectiveness of an information system in head and neck cancer care.
OBJECTIVE
To determine use, appreciation and effectiveness of an electronic health information support system in head and neck (H&N) cancer care.


METHODS
A prospective evaluation study. The evaluated system has four different functions: (1) communication amongst health care providers and between health care providers and patients, (2) information for health care providers and patients, (3) contact with fellow sufferers and (4) monitoring of discharged patients by means of electronic questionnaires. Evaluation of the system was done both objectively using automatically created log files and stored messages, and subjectively by using paper questionnaires from patients and general practitioners (GPs).


METHODS
Department of Otorhinolaryngology and Head and Neck Surgery of a tertiary health care centre in the Netherlands. The system was put at patients' disposal for a period of 6 weeks following discharge from the hospital after surgery for H&N cancer, and was additional to standard care.


METHODS
Head and neck cancer patients, hospital physicians, members of a hospital-based support team, GPs, district nurses and speech therapists.


METHODS
Actual use of the system by patients and health care providers. Patients' appreciation for each of the system's four different functions. GPs' appreciation for the system. Capability to detect potential patient problems with the system.


RESULTS
The system was used by 36 H&N cancer patients, 10 hospital physicians, 2 members of the support team, 8 GPs, 2 district nurses and 2 speech therapists. The total number of patient-sessions was 982: an average of 27.3 sessions per patient during the 6 weeks study period. In total, 456 monitoring questionnaires were completed. The support team in hospital responded with 231 actions. In 16 cases, an extra appointment was made for a patient with the hospital physician. Out of these cases, immediate action was considered necessary eight times. Patients appreciated the system highly, rating it with an average score of 8.0 on a 10-point scale. All patients used the monitoring function, and rated 'monitoring' with a mean score of 8.0 on a 10-point scale. Least used and appreciated was the 'contact with fellow sufferers' function. Only 8 out of possible 36 GPs used the system, rating it with an average of 5.6 on a 10-point scale.


CONCLUSIONS
The electronic health information support system was used intensively and highly appreciated by H&N cancer patients. The system enabled the early detection of occurring health problems that required direct intervention. ICT can play an additional role in the management of patients, also in a relatively elderly and computer illiterate patient population.
van den Brink
Jaap L
JL
Department of Medical Informatics, Erasmus MC, Dr. Molewaterplein 50, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. j.vandenbrink@erasmusmc.nl
Moorman
Peter W
PW
de Boer
Maarten F
MF
Pruyn
Jean F A
JF
Verwoerd
Carel D A
CD
van Bemmel
Jan H
JH
D000328:Adult; D000368:Aged; D003142:Communication; D004581:Electronics; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D007256:Information Systems; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010348:Patient Care Team; D010351:Patient Discharge; D010353:Patient Education as Topic; D010358:Patient Participation; D017060:Patient Satisfaction; D010564:Personnel, Hospital; D011446:Prospective Studies