Development of an eHealth System to Capture and Analyze Patient Sensor and Self-Report Data: Mixed-Methods Assessment of Potential Applications to Improve Cancer Care Delivery

Abstract

BackgroundCapturing and Analyzing Sensor and Self-Report Data for Clinicians and Researchers (COMPASS) is an electronic health (eHealth) platform designed to improve cancer care delivery through passive monitoring of patients’ health status and delivering customizable reports to clinicians. Based on data from sensors and context-driven administration of patient-reported outcome (PRO) measures, key indices of patients’ functional status can be collected between regular clinic visits, supporting clinicians in the delivery of patient care.ObjectiveThe first phase of this project aimed to systematically collect input from oncology providers and patients on potential clinical applications for COMPASS to refine the system.MethodsTen clinicians representing various oncology specialties and disciplines completed semi-structured interviews designed to solicit clinician input on how COMPASS can best support clinical care delivery. Three cancer patients tested a prototype of COMPASS for 7 days and provided feedback. Interview data were tabulated using thematic content analysis to identify the most clinically relevant objective and PRO domains.ResultsThematic content analysis revealed that clinicians were most interested in monitoring vital statistics, symptoms, and functional status, including the physical activity level (n=9), weight (n=5), fatigue (n=9), sleep quality (n=8), and anxiety (n=7). Patients (2 in active treatment and 1 in remission) reported that they would use such a device, were enthusiastic about their clinicians monitoring their health status, especially the tracking of symptoms, and felt knowing their clinicians were monitoring and reviewing their health status provided valuable reassurance. Patients would, however, like to provide some context to their data.ConclusionsClinicians and patients both articulated potential benefits of the COMPASS system in improving cancer care. From a clinician standpoint, data need to be easily interpretable and actionable. The fact that patients and clinicians both see potential value in eHealth systems suggests wider adoption and utilization could prove to be a useful tool for improving care delivery.

Digital health for optimal supportive care in oncology: benefits, limits, and future perspectives

“… 65 nurses; 12 physicians N/A – - High usefulness by nurses and physicians; higher use among nurses Ruland [ 39 ] RCT (availability of PRO data vs No PRO data before consultation) 145 Patients starting antileukemia or -lymphoma treatment - PRO data availability before visits led to 1) addressing more symptoms during consultation; 2) significant decrease of symptom distress; 3) significant reduction in need for symptom management support – Ruland [ 40 ] COMPASS (Capturing and Analyzing Sensor and Self-Report Data for Clinicians and Researchers) Yes Smartphone-based app and wearable heart rate monitor device-agnostic eHealth technology platform that can passively and remotely monitor multiple domains of function and PROs Passive monitoring of patients’ health status No Only customizable reports to clinicians Feasib. 3 patients; 10 HCPs Cancer patients and HCPs - Feasible; reassuring; highest interest in symptom monitoring - Feasible; highest interest in monitoring of vital signs and medication adherence Lucas [ 41 ] eCO (eCediranib/Olaparib) Yes Smartphone-based app. Blood pressure monitor linked to the app via Bluetooth and diarrhea symptom management Yes b Smartphone app and phone-based Pilot 16 Patients with recurrent ovarian cancer enrolled in a phase II study of cediranib/olaparib (NCT 02345265) - Feasible.…”

“…From the patient perspective, some of the key factors identified for the uptake of the digital tools included the following: Ease of use [ 30 , 38 , 44 , 51 , 53 , 55 , 64 , 80 ]; Reassurance [ 28 , 30 , 41 , 48 , 49 , 55 , 59 , 70 ]; High usability and usefulness [ 37 , 42 , 44 , 58 , 62 , 74 ]; Improved communication with HCPs [ 27 , 29 , 30 , 53 , 58 ] www.owise.uk ; Correct generation of system alerts and fast response to alerts [ 28 , 70 , 80 ]; Patient empowerment [ 29 , 30 , 69 ]; and The convenience of real-time reporting of symptoms [ 28 , 37 ]; …”

The Use of Demoralization Scale in Italian Kidney Transplant Recipients

“…Each patient was individually administered the Mini-International Neuropsychiatric Interview (MINI6.0) [32] and the DCPR interview [33], which both took about two hours. Before the diagnostic interviews, the patients filled in four self-report instruments: DS-IT [27], Post-Traumatic Growth Inventory (PTGI) [34,35], Edmonton Symptom Assessment System (ESAS-Revised) [8,[36][37][38], and Canadian Problem Checklist (CPC) [39,40] (Table 1). In agreement with other screening programs [39], we administered together the ESAS and the Canadian Problem Checklist (CPC) within the COMPASS tool (Comprehensive Problem and Symptom Screening) [40].…”

“…Canadian Problem Checklist (CPC) [39,40] It consists of a list of 21 problems each rated in a yes/no (0-1) format and grouped into 6 categories: practical, social/family, emotional, spiritual, informational, and physical problems.…”

Intensification of data processing and obtaining new information on multidimensional signals of the "electronic nose"

“…К многомерным аналитическим сигналам относятся отклики мультисенсорных систем типа искусственных "носа, глаза, языка". Для таких систем не характерны, но возможны традиционные качественный (идентификация отдельных компонентов сложных смесей) и количественный (определение содержания каждого компонента) анализ [1][2][3][4][5]. Для сравнения двух и более проб, для установления причин возможных различий их состояния применяют метод хемометрикиметод обработки сразу всех матриц выходных данных.…”