title: Review of electronic patient-reported outcomes systems used in cancer clinical care.
abstract: OBJECTIVE
  The use of electronic patient-reported outcomes (PRO) systems is increasing in cancer clinical care settings. This review comprehensively identifies existing PRO systems and explores how systems differ in the administration of PRO assessments, the integration of information into the clinic workflow and electronic health record (EHR) systems, and the reporting of PRO information.
  
  
  METHODS
  Electronic PRO (e-PRO) systems were identified through a semistructured review of published studies, gray literature, and expert identification. System developers were contacted to provide detailed e-PRO system characteristics and clinical implementation information using a structured review form.
  
  
  RESULTS
  A total of 33 unique systems implemented in cancer clinical practice were identified. Of these, 81% provided detailed information about system characteristics. Two system classifications were established: treatment-centered systems designed for patient monitoring during active cancer treatment (n = 8) and patient-centered systems following patients across treatment and survivorship periods (n = 19). There was little consensus on administration, integration, or result reporting between these system types. Patient-centered systems were more likely to provide user-friendly features such as at-home assessments, integration into larger electronic system networks (eg, EHRs), and more robust score reporting options. Well-established systems were more likely to have features that increased assessment flexibility (eg, location, automated reminders) and better clinical integration.
  
  
  CONCLUSIONS
  The number of e-PRO systems has increased. Systems can be programmed to have numerous features that facilitate integration of PRO assessment and routine monitoring into clinical care. Important barriers to system usability and widespread adoption include assessment flexibility, clinical integration, and high-quality data collection and reporting.
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; The Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Duke Comprehensive Cancer Center, Duke University Medical Center, Durham; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Health Outcomes Group, Memorial Sloan-Kettering Cancer Center, New York, NY rj222@georgetown.edu.
authors.forename: Roxanne E
authors.initials: RE
authors.lastname: Jensen
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; The Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Duke Comprehensive Cancer Center, Duke University Medical Center, Durham; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Health Outcomes Group, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Claire F
authors.initials: CF
authors.lastname: Snyder
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; The Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Duke Comprehensive Cancer Center, Duke University Medical Center, Durham; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Health Outcomes Group, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; The Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Duke Comprehensive Cancer Center, Duke University Medical Center, Durham; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Health Outcomes Group, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Ethan
authors.initials: E
authors.lastname: Basch
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; The Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Duke Comprehensive Cancer Center, Duke University Medical Center, Durham; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Health Outcomes Group, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Arnold L
authors.initials: AL
authors.lastname: Potosky
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; The Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Duke Comprehensive Cancer Center, Duke University Medical Center, Durham; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Health Outcomes Group, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Aaron C
authors.initials: AC
authors.lastname: Roberts
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; The Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Duke Comprehensive Cancer Center, Duke University Medical Center, Durham; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Health Outcomes Group, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Deena R
authors.initials: DR
authors.lastname: Loeffler
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; The Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Duke Comprehensive Cancer Center, Duke University Medical Center, Durham; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Health Outcomes Group, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Bryce B
authors.initials: BB
authors.lastname: Reeve
mesh_terms: D003625:Data Collection; D057286:Electronic Health Records; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D063868:Patient Outcome Assessment