Healthcare Professionals’ Perspectives on ePROMs in Surgical Breast Cancer Follow-Up: A Mixed-Methods Study

Abstract

Background: The growing number of breast cancer survivors underscores the need for tailored follow-up care, particularly focussing on person-centred outcomes in surgical follow-ups. Electronic patient-reported outcome measures (ePROMs) have the potential to enhance person-centred care (PCC) by systematically integrating patient perspectives into clinical practice. However, the barriers and facilitators for the utilization of ePROMs in surgical breast cancer follow-ups remain unclear.

Methods: This study utilized a sequential explanatory mixed-methods design. Quantitative data were collected via a survey among healthcare professionals (HCPs) to assess their familiarity with and perspectives on ePROMs. These findings informed focussed ethnographic qualitative research, including participant observations and interviews, to explore the practical application of ePROMs in clinical practice. Data integration involved a joint display analysis to develop comprehensive insights.

Results: While most HCPs (88%) expressed interest in learning more about ePROMs, only 20% agreed that ePROMs improved treatment and care. Time constraints (reported by 56%) and limited system integration (68% were unfamiliar with access via EMR) were reported as key barriers. Nurses prioritized experiential and patient-specific approaches, often relying on intuition rather than systematic use of ePROMs, whereas surgeons viewed ePROMs as tools for improving resource allocation and surgical outcomes. Knowledge gaps and a lack of organizational support were prevalent, hindering the consistent application of ePROMs in routine care.

Conclusions: ePROMs have untapped potential to transform surgical follow-ups in breast cancer care by aligning clinical practices with person-centred outcomes. Effective integration requires addressing technical and organizational barriers, enhancing HCPs’ competencies and fostering a supportive culture for systematic ePROM utilization. Tailored implementation strategies are a key to fully realizing the benefits of ePROMs in achieving PCC.