Development and implementation of a clinician reporting system for advanced stage cancer: initial lessons learned.
OBJECTIVE
Innovative approaches can strengthen patient-caregiver-clinician information exchange and more effectively address the physical and psychosocial challenges of advanced disease. This study reports initial findings from implementation of the Clinician Report (CR)-a patient and caregiver status report tool accessible by the oncology clinic team.


METHODS
The CR tracks and communicates essential information from cancer patients and caregivers to the oncology team. The CR conveys patient symptoms, emotional strain, and key concerns.


METHODS
Authors used a model developed to explain acceptance, implementation, and sustainability of Interactive Health Communication Systems (IHCS) to evaluate implementation of the new CR system. The study carried out qualitative analyses of interviews with clinicians regarding their experience utilizing the Clinician Report.


RESULTS
Primary CR benefits included enhancement of patients' clinic visit experiences, greater caregiver involvement, and facilitation of earlier interventions. Challenges included CR functional issues, users' desire for greater depth of information, user privacy concerns, and limited patient use. These findings are discussed using parameters of the implementation model. Limitations of this study include its small clinician sample size, which represented only a portion of existing organizational settings in which CR systems might be implemented.


CONCLUSIONS
Though in its early implementation stages, the CR demonstrates the potential to positively impact care delivery in the cancer clinic setting, particularly by facilitating earlier interventions and improving patient-caregiver-clinician communication both during and between clinic visits.
Dubenske
Lori L
LL
Center for Health Enhancement Systems Studies, University of Wisconsin, Madison, Wisconsin, USA. LDuBenske@chess.wisc.edu
Chih
Ming-Yuan
MY
Dinauer
Susan
S
Gustafson
David H
DH
Cleary
James F
JF
D001291:Attitude of Health Personnel; D017028:Caregivers; D020000:Decision Support Systems, Clinical; D006284:Health Plan Implementation; D055991:Health Records, Personal; D006801:Humans; D020407:Internet; D009369:Neoplasms / Q000628:therapy*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D017216:Telemedicine / Q000379:methods*; D014481:United States; D014584:User-Computer Interface