Exploratory analysis of electronic patient-reported outcomes collection: comparing online and in-clinic modalities in cancer care.

Abstract

Purpose: Patient reported outcome measures (PROMs) have been shown to improve cancer survival but are generally underutilized in cancer care. It is unclear whether electronic-PROMS (ePROMs) modality (online vs. in-clinic) may address barriers to completion. We examined whether patient sociodemographic and clinical factors differed by completion modality.

Methods: Patients with cancer who had an oncologic provider visit from January 2021 to March 2023 at a tertiary cancer center were assigned the National Institute of Health's computer adaptive technology Patient-Reported Outcomes Measurement Information System instruments. Patients completed ePROMs either through online patient portal (online) up to 7 days before the visit or used a tablet at the clinic visit (in-clinic) if not completed online. Multivariable logistic regression model estimated associations between patient sociodemographic and clinical factors and completion modality.

Results: A total of 8556 patients completed ePROMs (43.3% completed in-clinic). Females were less likely than males to complete ePROMs in-clinic (aOR = 0.89, 0.84-0.93) as were patients with commercial insurance (aOR = 0.83, 0.77-0.89) vs. Medicare; or saw radiation oncologist (aOR = 0.89, 0.83-0.96) vs. medical oncologist. However, patients were more likely to complete ePROMs in-clinic if they identified as Black race (aOR = 1.41, 1.33-1.49) vs. White; were single (aOR = 1.21, 1.14-1.29) or divorced/separated/widowed (aOR = 1.11, 1.04-1.18) vs. married; or saw a provider located in rural (aOR = 1.33, 1.25-1.42) vs. urban area.

Conclusions: Patients who were males, Blacks, unmarried, Medicare insured or saw providers located in rural area were more likely to complete ePROMs in-clinic. Given the preference for online completion before visits for real-time symptom monitoring, targeted efforts are needed to boost online PROMs completion.

Plain message: This is a cross-sectional analysis of the associations between sociodemographic and clinical factors with two electronic patient reported outcome measures completion modalities. The results indicate that about half of patients completed online and half completed in-clinic, with males, Blacks, patients who were divorced/separated/widowed, had Medicare insurance and saw a medical oncologist completing electronic patient reported outcome measures in-clinic. We support offering both options while addressing barriers to either modality.