On a recent webinar hosted by Digital Health Canada, Dr. Jeremy Ho, a Medical Oncologist at Vancouver Coastal Health and the Richmond Hospital Cancer Care Clinic, shared insights and lessons learned on their use of Remote Symptom Monitoring (powered by SeamlessMD) to enhance the cancer journey for patients.
Remote Symptom Monitoring involves leveraging a patient’s own smartphone, tablet or computer to send patients reminders, deliver education, collect Patient-Reported Outcome Measures (PROMs) and remotely monitor symptoms - such as for side effects after chemotherapy treatment cycles.
Called RESPONSe: REmote Symptom and Patient mONitoring System, the goal of the program is to: “provide better patient centered care through the prompt management of treatment related symptoms with the goal of reducing symptom burden and ultimately decreasing the need for acute care visits.”
The RESPONSe program was also recently recognized by British Columbia Minister of Health Adrian Dix as a key innovation to support the opening of the new Richmond Cancer Clinic.
You can watch the whole webinar here. Below are 8 insights that Dr. Ho shared:
Dr. Ho’s oncology program had done patient focus group interviews which found:
Dr. Ho further explained: “We realized that even though we were trying to provide the best patient care, we weren’t meeting all of our patients’ needs. Our chemotherapy nurses were responsible for managing side effects of treatment, but as they became busier with more patients trying to deliver more chemotherapy, patients let us know they weren’t getting the care that they required.”
The oncology team realized that they needed a more proactive way to better support patients between treatment cycles and close the communication gap – eventually turning to technology.
“We knew we had to do better for our patients… We landed on the idea of moving from a REACTIVE to a PROACTIVE model of symptom management through the use of digital technology.”
Dr. Ho explained that the American Society of Clinical Oncology’s (ASCO) has long advocate for oncology programs to collect patient-reported outcome measures (PROMs) because their use has been associated with improved patient-provider communication, quality of life, lower symptom burden, lower use of acute care services and improved survival.
Implementing Remote Symptom Monitoring allowed the Richmond Cancer Clinic to quickly start collecting PROMs digitally – making it more convenient for both patients and clinicians to benefit from PROMs.
Here’s the Remote Symptom Monitoring approach the oncology team took:
The oncology team also has the platform prompt the patient to complete a survey 2 days before their next doctor’s visit so they can share any concerns ahead of time – leading to a more productive conversation during the actual encounter.
While some oncology programs that provide Remote Symptom Monitoring focus only on tracking symptoms, Dr. Ho explained how the Richmond Cancer Clinic wanted to ensure patients were continuously empowered with the right patient education:
“Patients have access at any time to our comprehensive digital library which includes extensive resources about cancer, practicalities of cancer treatment and how to manage side effects.”
Dr. Ho shared how his team did not want to simply collect PROMs. Rather, they used branching (or adaptive logic) functionality to design 13 unique symptom questioning branches that would be useful to alter the clinical response to patients in a meaningful way. The team used the COSTARs symptom practice guide to help inform the approach.
For example, if a patient reports having constipation, they automatically receive follow up questions on severity, days since last bowel movement, presence of abdominal pain, and so on.
From there, the platform automatically provides an action plan based on the severity – from providing self-care management education directly to patients for low-severity to prompting the oncology team to contact the patients for high-severity.
Already the Richmond Cancer Clinic has demonstrated incredible results over the first 30 patients (as of March 31, 2024):
The patient feedback has also been fantastic. As one patient shared: “I feel extremely confident managing my symptoms as I go through treatment, because I noticed the symptom management nurse responded quickly.”
Anecdotal reports from patients, nurses and physicians show the program to have many benefits, including:
Dr. Ho further explained: “Our chemotherapy nurses find they can focus on administering chemotherapy to the patients in front of them instead of managing the phone line. Physicians find that this has taken work off our plate since the symptom management nurses doing the monitoring is an effective go-between for assessing and managing patient symptoms.”
Vancouver Coastal Health and the Richmond Cancer Clinic partnered with SeamlessMD for their Remote Symptom Monitoring program.
If you are keen to learn how we could help you do the same, contact us here.
For more information about how SeamlessMD supports oncology programs, click here to learn more.