title: Use of an electronic patient-reported outcome measurement system to improve distress management in oncology.
abstract: OBJECTIVE
  Management of patient distress is a critical task in cancer nursing and cancer practice. Here we describe two examples of how an electronic patient-reported outcome (ePRO) measurement system implemented into routine oncology care can practically aid clinical and research tasks related to distress management.
  
  
  METHODS
  Tablet personal computers were used to routinely complete a standardized ePRO review of systems surveys at point of care during every encounter in the Duke Oncology outpatient clinics. Two cases of use implementation are explored: (1) triaging distressed patients for optimal care, and (2) psychosocial program evaluation research.
  
  
  RESULTS
  Between 2009 and 2011, the ePRO system was used to collect information during 17,338 Duke Oncology patient encounters. The system was used to monitor patients for psychosocial distress employing an electronic clinical decision support algorithm, with 1,952 (11.3%) referrals generated for supportive services. The system was utilized to examine the efficacy of a psychosocial care intervention documenting statistically significant improvements in distress, despair, fatigue, and quality of life (QOL) in 50 breast cancer patients.
  
  
  CONCLUSIONS
  ePRO solutions can guide best practice management of cancer patient distress. Nurses play a key role in implementation and utilization.
authors.affiliation: Center for Learning Health Care, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
authors.forename: Sophia K
authors.initials: SK
authors.lastname: Smith
authors.affiliation: Department of Medicine, Division of Cellular Therapy, Duke University, Durham, North Carolina.
authors.forename: Krista
authors.initials: K
authors.lastname: Rowe
authors.affiliation: Center for Learning Health Care, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
mesh_terms: D000223:Adaptation, Psychological; D001008:Anxiety Disorders / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology*; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology*; D057286:Electronic Health Records; D006801:Humans; D033183:Interdisciplinary Communication; D008403:Mass Screening / Q000451:nursing*; D009369:Neoplasms / Q000175:diagnosis / Q000451:nursing* / Q000473:pathology / Q000523:psychology*; D009730:Nursing Assessment / Q000458:organization & administration; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D058996:Quality Improvement / Q000458:organization & administration*; D012803:Sick Role; D012984:Software; D014218:Triage / Q000458:organization & administration