title: Implementing touch-screen technology to enhance recognition of distress.
abstract: OBJECTIVE
  The University of California, San Diego, Moores Cancer Center implemented a systematic approach for patients to communicate with their health-care team in real-time regarding psychosocial problem-related distress using touch-screen technology. The purpose of this report is to describe our experience in implementing touch-screen problem-related distress screening as the standard of care for all outpatients in a health-care setting. Although early identification of distress has recently gained wide attention, the practical issues of implementing psychosocial screening with and without the use of technology have not been fully addressed or investigated.
  
  
  METHODS
  'The How Can We Help You and Your Family?' screening instrument was used to identify and address patient problem-related distress for clinical services, program development, research and education. Using a HIPPA-compliant approach, the touch-screen technology also helped to identify patients interested in clinical trials and additional support services.
  
  
  RESULTS
  We found that the biggest barrier to implementing this technology was the attitude of the front desk staff (i.e. schedulers, clerks, administrative staff) who felt that the touch-screen would be burdensome. Our experience suggested that it was essential to actively involve these personnel from the beginning of the planning process. As specifically acknowledged in the recent 2007 Institute of Medicine report (Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The National Academies Press: Washington, DC, 2007), use of this computerized version of the screening instrument was able to bridge the gap between the detection of problem-related distress and referrals for assessment or treatment.
  
  
  CONCLUSIONS
  We found that it is feasible to implement a computerized problem-related distress screening program in a comprehensive cancer center.
authors.affiliation: Sheri & Les Biller Patient and Family Resource Center, City of Hope, Duarte, CA, USA. kclark@coh.org
authors.forename: K
authors.initials: K
authors.lastname: Clark
authors.forename: W A
authors.initials: WA
authors.lastname: Bardwell
authors.forename: T
authors.initials: T
authors.lastname: Arsenault
authors.forename: R
authors.initials: R
authors.lastname: DeTeresa
authors.forename: M
authors.initials: M
authors.lastname: Loscalzo
mesh_terms: D000553:Ambulatory Care; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D001291:Attitude of Health Personnel; D002140:California; D002173:Cancer Care Facilities; D003142:Communication; D003195:Computer Communication Networks; D003197:Computer Literacy; D003863:Depression / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007318:Inservice Training; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D010348:Patient Care Team; D011340:Problem Solving; D012017:Referral and Consultation; D012984:Software; D011795:Surveys and Questionnaires; D014584:User-Computer Interface; D016526:Workload / Q000523:psychology