Article Text
Abstract
Introduction Extended patient survival has shifted focus in oncology to patient experience and quality-of-life, measured through patient-reported outcome (PROM) instruments. Increasing use of oral therapies and the advent of digital technologies allow scaling back in-person encounters with healthcare teams. Building on pandemic-driven experience, we developed a remote monitoring platform (RMCC) for gyn oncology patients on systemic treatment, aimed to provide a comprehensive, continuous care experience and optimize outcomes.
Methods Patients beginning systemic treatment for gynecologic cancers at a tertiary cancer center are offered enrollment. Following initial multidisciplinary evaluation, patients are monitored with wearable devices for physiological measures and digitally collected PROMs for disease- and treatment-associated symptoms and toxicities. A case-manager follows a virtual dashboard and manages patient symptoms and concerns with guidance from responsible physicians. Pre-defined outcomes, including clinical and functional measures, patient experience and healthcare services consumption are collected.
Results Over four months since initiation, 23 patients were enrolled (14 ovarian, 7 uterine, 2 cervix). 18/23 (78%) were receiving 1st line systemic chemotherapy. 1922 system alerts were triggered: 37% by PROMs, 16% by physiologic measures and 42% self-initiated. EORTC PATSAT questionnaires demonstrated high participant satisfaction in healthcare team-dependent domains. Patients enrolled in RMCC had fewer ER visits and unplanned admissions, and more planned supportive ambulatory encounters (nursing, psychology, nutrition, social work, complementarymedicine) than patients receiving standard care.
Conclusion/Implications The use of remote monitoring systems improves patient experience, reduces consumption of emergency medical services, and could expand access to tertiary services in remote communities. Longer-term outcomes will be assessed over time.