Improving health care efficiency and quality using tablet personal computers to collect research-quality, patient-reported data.

摘要: Patient-reported outcomes (PROs) have increasingly gained acceptance as important and valid measures of symptoms, experiences, health-related quality life (HRQOL), thus critical metrics for evaluating the value health care services to patients (Ganz 1994; Cella et al. 1997; Coates, Porzsolt, Osoba Dancey 1997). Major policy making entities which emphasized importance incorporating PROs into cancer research formation (Lipscomb, Gotay, Snyder 2007) include National Cancer Institute (2008), American Society (2007), U.S. Food Drug Administration ( Johnson, Williams, Pazdur 2003; Department Health Human Services 2007), Centers Medicare & Medicaid (2004), Institutes (2007). These agencies' interest in reflects a growing national recognition that traditional medical (i.e., survival, disease progression) do not fully capture patient's experience health, an acknowledgement patients' self-perceived well-being is outcome, new definition “value” includes improvement subjective patients. The two principal, if only, methods gathering before advent electronic methodologies are paper survey clinician interview, both labor time-intensive methodologies. In order be routinely integrated clinical practice, PRO data collection must efficient, is, they easy, rapid, convenient, inexpensive, reliable, clinically feasible (Cella 1995). Newly introduced technologies revolutionized available researchers offer new, more efficient tools management. Studies diverse populations found technology-based well received by patients, preferred over paper-based instruments (Skinner Allen 1983; O'Connor, Hallam, Hinchcliffe 1989; Drummond 1995; Lewis 1996; Yarnold Velikova 1999; Ruland 2003). A recent study also regular, repeated, feedback physicians, addition facilitating physician–patient communication, positive impact on HRQOL emotional functioning (Velikova 2004). meta-analysis 65 studies directly assessed equivalence computer versus versions used trials paper-administered equivalent methodologies, with very small mean differences were neither statistically or significant (Gwaltney, Shields, Shiffman 2008). findings compare between assessments moved from versions, cannot generalized all forms administration (Gwaltney 2008). The e/Tablet technology utilized present validated, widely implemented, HIPAA-compliant wireless tablet use at point complete surveys (Figure 1). The feeds database system, longitudinally warehouses locally and/or across multiple sites. network >110 community oncology practices United States currently uses e/Tablets administer review systems (ROS) instrument, Patient Care Monitor™ (PCM), collects symptom, QOL, performance status information (Fortner Doctors participating these enhance care; ongoing suggests reception oncologists. Figure 1 e/Tablet Monitor Report To date, validity, acceptability, benefit been investigated academic setting. It assumed instrument validated one setting will perform equally another, nor system (e.g., PCM) prove similarly capable delivering other surveys). therefore validity acceptability confirm previous settings patient populations.