title: Development and Feasibility Testing of PROMPT-Care, an eHealth System for Collection and Use of Patient-Reported Outcome Measures for Personalized Treatment and Care: A Study Protocol.
abstract: BACKGROUND
  Patient-reported outcome (PRO) measures have been used widely to screen for depression, anxiety, and symptoms in cancer patients. Computer-based applications that collect patients' responses and transfer them to the treating health professional in real time have the potential to improve patient well-being and cancer outcomes.
  
  
  OBJECTIVE
  This study will test the feasibility and acceptability of a newly developed eHealth system which facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions and patient self-management, and data retrieval to support ongoing evaluation and innovative research.
  
  
  METHODS
  The eHealth system is being developed in consultation with 3 overarching content-specific expert advisory groups convened for this project: the clinical advisory group, technical advisory group, and evaluation advisory group. The following work has already been completed during this phase of the study: the Patient-Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) eHealth system was developed, patient-reported outcomes were selected (distress, symptoms, unmet needs), algorithms to inform intervention thresholds for clinical and self-management were determined, clinician PRO feedback summary and longitudinal reports were designed, and patient self-management resources were collated. PROsaiq, a custom information technology system, will transfer PRO data in real time into the hospital-based oncology information system to support clinical decision making. The PROMPT-Care system feasibility and acceptability will be assessed through patients completing PROMPT-Care assessments, participating in face-to-face cognitive interviews, and completing evaluation surveys and telephone interviews and oncology staff participating in telephone interviews.
  
  
  RESULTS
  Over the course of 3 months, the system will be pilot-tested with up to 50 patients receiving treatment or follow-up care and 6 oncology staff at 2 hospitals in New South Wales, Australia. Data will be collected to determine the accuracy and completeness of data transfer procedures, extent of missing data from participants' assessments, acceptability of the eHealth system and usefulness of the self-management resources (via patient evaluation surveys and interviews), and acceptability and perceived usefulness of real-time PRO reporting (via oncology staff interviews) at the completion of the pilot phase.
  
  
  CONCLUSIONS
  This research investigates implementation of evidence into real world clinical practice through development of an efficient and user-friendly eHealth system. This study of feasibility and acceptability of the newly developed eHealth system will inform the next stage of larger scale testing and future implementation of the system as part of routine care.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN1261500135294; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369299&isReview=true (Archived by WebCite at http://www.webcitation.org/6lzylG5A0).
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.|Department of Medicine, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.
authors.forename: Afaf
authors.identifier: http://orcid.org/0000-0003-4101-4006
authors.initials: A
authors.lastname: Girgis
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.|Department of Medicine, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.|Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia.
authors.forename: Geoff P
authors.identifier: http://orcid.org/0000-0002-1829-396X
authors.initials: GP
authors.lastname: Delaney
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.|Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia.
authors.forename: Anthony
authors.identifier: http://orcid.org/0000-0003-4866-8125
authors.initials: A
authors.lastname: Arnold
authors.affiliation: Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia.|Centre for Oncology Informatics, University of Wollongong, Wollongong, Australia.
authors.forename: Alexis Andrew
authors.identifier: http://orcid.org/0000-0003-3044-3358
authors.initials: AA
authors.lastname: Miller
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.|Department of Medicine, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.
authors.forename: Janelle V
authors.identifier: http://orcid.org/0000-0001-6982-2086
authors.initials: JV
authors.lastname: Levesque
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.|Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia.
authors.forename: Nasreen
authors.identifier: http://orcid.org/0000-0003-1274-1212
authors.initials: N
authors.lastname: Kaadan
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.|Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia.|Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.
authors.forename: Martin G
authors.identifier: http://orcid.org/0000-0001-6671-029X
authors.initials: MG
authors.lastname: Carolan
authors.affiliation: Cancer Institute New South Wales, Sydney, Australia.
authors.forename: Nicole
authors.identifier: http://orcid.org/0000-0003-4439-4200
authors.initials: N
authors.lastname: Cook
authors.affiliation: Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia.
authors.forename: Kenneth
authors.identifier: http://orcid.org/0000-0003-2213-0175
authors.initials: K
authors.lastname: Masters
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.|Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia.
authors.forename: Thomas T
authors.identifier: http://orcid.org/0000-0003-0367-5065
authors.initials: TT
authors.lastname: Tran
authors.affiliation: Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia.
authors.forename: Tiffany
authors.identifier: http://orcid.org/0000-0002-8935-7676
authors.initials: T
authors.lastname: Sandell
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.
authors.forename: Ivana
authors.identifier: http://orcid.org/0000-0002-9568-0058
authors.initials: I
authors.lastname: Durcinoska
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.
authors.forename: Martha
authors.identifier: http://orcid.org/0000-0002-8493-7196
authors.initials: M
authors.lastname: Gerges
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.|Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia.
authors.forename: Sandra
authors.identifier: http://orcid.org/0000-0003-3444-573X
authors.initials: S
authors.lastname: Avery
authors.affiliation: Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, Australia.|Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia.
authors.forename: Weng
authors.identifier: http://orcid.org/0000-0003-2354-1857
authors.initials: W
authors.lastname: Ng
authors.affiliation: Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, Australia.
authors.forename: Stephen
authors.identifier: http://orcid.org/0000-0003-1017-5595
authors.initials: S
authors.lastname: Della-Fiorentina
authors.affiliation: Faculty of Science, Central Clinical School, The University of Sydney, Sydney, Australia.
authors.forename: Haryana M
authors.identifier: http://orcid.org/0000-0003-4039-5169
authors.initials: HM
authors.lastname: Dhillon
authors.affiliation: Didymo Designs, Wollongong, Australia.
authors.forename: Ashley
authors.identifier: http://orcid.org/0000-0002-9259-1666
authors.initials: A
authors.lastname: Maher
keywords: PROMPT-Care; eHealth, self-management; electronic medical records; oncology; oncology information systems; patient-centered care; patient-reported outcomes; real-time report