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5 ePROs Myths That Are Keeping Your Practice from Streamlining Care

Any practice gets nervous about the idea of adding another layer to its technology stack. Let's explore the myths and facts of ePROs.

ePROs, or electronic patient-reported outcomes, are reported to increase survival by over 20% when integrated into routine cancer care. Earlier recognition of treatment toxicity keeps a small problem from becoming a big problem yet offering opportunities for regular patient reporting is often easier said than done. Facilities worry that adopting new digital tools for patients, like symptom reporting, will lead to decreased efficiency or increased administrative burden for their already burnt-out teams. Will this cause more work for me? Will anyone use this? Are we wasting money? These are just some of the most common questions practices ask themselves. However, the right technology partner and toolset can ensure that care teams can boost patient outcomes without becoming overwhelmed by administrative headaches. 

Any practice gets nervous about the idea of adding another layer to its technology stack, but it’s time to do a little myth-busting and understand how utilizing ePROs could very well improve patient care and experience, reduce staff burnout, and streamline the day-to-day operations at your facility.

Myth #1 - Patients Just Won’t Use It

A top concern for many practices is that patients are used to calling in directly to their practice and won’t like using a mobile app. However, we know that patients today are incredibly digitally savvy and very used to managing most aspects of their life like banking, insurance, and credit card bills online. Using healthcare portals or researching health information online is commonplace for most today.  Patients want to interact with care teams when given the opportunity, and one study published by the Journal of Clinical Oncology indicated that engagement with Canopy’s ePROs app and IVR (interactive voice response) system was 88% at 6 months, with 12-month retention at greatest among patients 65 years or older.¹

88% ePRO engagement at 6 months¹

22% reduction in ER visits²

22%-45% increased treatment persistence at 3 months³

ePROs provide patients with greater autonomy in their care journey and eliminate many fears and stresses associated with calling a practice. Various social determinants of health and cultural factors can cause individuals to fear “bothering the doctor” or navigating complex phone tree lines. For example, those who don’t speak English may be nervous to call the practice due to a fear of not being understood. There is also a certain amount of psychological stress and fear associated with calling the practice; patients worry that symptoms could indicate a need to go to the ER or a sign that the disease is progressing.

Nobody wants to call the doctor’s office and this (Canopy’s ePRO-Based Patient Monitoring) is much less intimidating. Patients are scared, and this is a lifeline for them.

—Maggie Black, Nursing Manager, Cancer Specialists of North Florida

Myth #2 - Patients Will Expect Instant Response, Leading to Staff Burn-Out

Staff burnout is certainly a real problem withover 55% of front-line healthcare workers reporting mental and physical exhaustion. Practices may worry that patients will expect instant responses, and staff will be expected to answer emails and calls day and night.

Practices had the same fears regarding patient portals years ago as they worried that patients would constantly message their doctors or misread complex medical test results leading to alarm. However, many facilities soon implemented clear policies, like a 24-hour delay before results appear, so a referring provider can speak to a patient first. Some also added messages in the portal that say to allow physicians up to 24 hours for non-urgent requests.  ePROs can easily have the same safeguards in place, too. Practices set the expectation for availability with patients. You can set working hours within the app’s messaging and provide after-hours messaging as well. During patient enrollment and within the app/IVR messaging, patients are informed that they will receive a response if necessary, and patients can also list their callback preferences.

A significant contributor to burnout is spending too much time on tools and less time with patients. However, the right suite of tools can alleviate burnout and act as the trusted staff member you’ve always dreamt of. Canopy partnered with oncology practices to develop Intelligent Patient Relationship Management solutions, empowering care teams to efficiently scale quality care. Teams can intake remote patient touch points, like symptom reports or other requests, into a centralized Work Queue that intelligently prioritizes patient-related tasks. Standardized symptom triage helps nurses make the right decisions faster through symptom-specific pathways, intelligent alerting, and EMR-integrated auto-documentation.

29,000 symptom reports¹

31% required action¹

~6% required an office visit¹

Practices like Northwest Medical Specialities sought to utilize its technology partners to reduce administrative tasks for its staff and increase efficiency across the practice. Amy Ellis, Chief Operating Officer at Northwest Medical Specialities, knew that she was going to have to educate her team on why and how Canopy would make a difference in their day-to-day lives.  Amy said, “I helped them look through my lens. I said, hey, I want to implement this system because I'm hearing from you that you're frustrated about your cross-coverage. I heard you were out sick and when you came back your work wasn’t done." Today, ticketing capabilities have offered improved response coordination and quality with a 9-minute response time to patient symptom-related phone calls.

Triage pathways and standing orders have also helped reduce burnout for providers. In fact, out of 29,000 reports submitted by patients, the Canopy platform was able to optimize and prioritize staff work, identifying that only 31% required some action and an even smaller percentage (~6%) required an office visit. [JCO, 2022]

Myth #3 - Patients Will Feel Ignored

Some practices worry that ePROS could negatively impact their patient satisfaction score if patients feel that they aren’t responded to quickly enough, or if they don’t understand that not all symptom reports need an immediate response. Education during the process is important, and patients need to be informed during enrollment that they will receive a response if necessary, and practices can set the expectation for availability. Patients can also share their communication and callback preferences. Canopy Platform data shows that callback requests account for only 7% of all symptom reports. At Highlands Oncology Group, Director and Canopy user, Traci Yeftich indicated that they could support more cancer patients with the same staff using Canopy. Staff are empowered to deliver the highest quality care, regardless of varying experience levels, and can offer more equitable care to patients without increasing their busy workloads.

“Highlands has become more operationally efficient since working with Canopy. Many departments have been able to streamline workflows and return calls faster. Our switchboard team creates tickets for incoming calls, and the smart template guides them through message entry. The ease of ticket entry and visibility of all calls on the dashboard has positively impacted our ability to respond to and care for patients.”

—Traci Yeftich, Director, Highlands Oncology Group

Ongoing patient symptom reporting, including symptoms that don’t require urgent responses, still helps to see long-term patterns, leading to new insights. Beth Page, Director of Compliance at Cancer Specialists of North Florida (CSNF) shared, “Analytics helped make our pain points more transparent.  We can also see key themes like how many patients on a certain drug end up in the ER on day three. We can then implement real-world changes.”

Myth 4 - Triage Nurses Won’t Have a Way To Organize Symptoms By Severity

Practices may be worried that overworked triage nurses won’t have a good way to manage urgent reports that should get responses.  Canopy’s proprietary, evidence-based Triage Pathways allow nursing teams to efficiently address 30 of the most common cancer side effects and deliver more standardized care. The advanced alerting and auto-documentation capabilities help nurses triage more efficiently and with more confidence (average completion time of 4 minutes).

Increasing cross-coverage and improving transparency and documentation have improved across teams and also improve long-term patient care. Beth Page at CSNF said, “Analytics has changed the way we make decisions. Today, we can look and see exactly how many patients are touched per day, how long answers are taking, and we can make adjustments to our staffing as a result.” For example, the tools and pathways provided by Canopy have allowed CSNF to reduce the triage team from 14 to four, and reallocate staff to other areas of the busy practice.

Myth 5 - Our Patients Don’t Have Smartphones

Facilities may worry that a patient population who isn’t smartphone savvy or doesn’t have access to smart devices can’t use ePROs. Smartphone adoption is rapidly increasing, with Pew Research showing that 85% of people in the US today own a smartphone. However, access to technology is not equal across all communities, which is why it’s important to offer alternative channels for patients to report symptoms. For example, patients without a smartphone or access to the internet can opt into interactive voice response (IVR), a short, automated phone call that surveys patients.

ePROs have been very popular across patient populations, even among elderly patients highlighting that they are ready for more digital tools. “We thought that the older population wouldn’t like it or embrace it, but they realize that it’s made their life much easier,” said Beth Page, Director of Compliance at Cancer Specialists of North Florida. Even caretakers utilize the app to regularly stay in touch with care teams.

Have we busted your ePROs myths? Ready to revolutionize patient care at your practice? Contact info@canopycare.us to learn how our platform can standardize care, improve daily workflows, and ultimately, improve patient care.

1. Cherny, N. I., Parrinello, C. M., Kwiatkowsky, L., Hunnicutt, J., Beck, T., Schaefer, E., Thurow, T., & Kolodziej, M. (2022). Feasibility of Large-Scale Implementation of an Electronic Patient-Reported Outcome Remote Monitoring System for Patients on Active Treatment at a Community Cancer Center. JCO Oncology Practice, 18(12), e1918-e1926. DOI: 10.1200/OP.22.00180
2. Kolodziej, M. A., Kwiatkowsky, L., Parrinello, C., Thurow, T., Schaefer, E. S., Beck, J. T., Cherny, N., & Blau, S. (2022). ePRO-based digital symptom monitoring in a community oncology practice to reduce emergency room and inpatient utilization. Journal of Clinical Oncology, 40(16_suppl), 1508.
Authors observed a 22 percent lower rate of adverse clinical events, specifically emergency room and hospital admission.
3. Parrinello, C., Calkins, G., Kwiatkowsky, L., Schaefer, E. S., Beck, J. T., Ellis, A. R., Blau, S., Telivala, B. P., & Kolodziej, M. A. (2022). Time on treatment is prolonged in patients utilizing an ePRO based digital symptom monitoring platform in the community setting. Journal of Clinical Oncology, 40(16_suppl), 1528. DOI: 10.1200/JCO.2022.40.16_suppl.1528