Real-time reports of symptoms in patients with cancer between clinician visits have health benefits, but price and technology are obstacles limiting prevalent use of the practice.1

“There’s tremendous value in integrating these patient-reported symptoms and other measures of how patients are feeling into clinical practice,” said author Ethan Basch, MD, MSc, director of the University of North Carolina Lineberger Cancer Outcomes Research Program in Chapel Hill, North Carolina.

“We’re almost there, but there are barriers that we need to overcome.”

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Previous research indicated that systematic collection of symptoms of patients via computer surveys was associated with less frequent emergency room admissions, longer average chemotherapy adherence, greater improvements in quality of life, and increased survival.

Nonetheless, collection of these patient-reported symptoms is not a standard of practice. Dr Basch encouraged health care providers to adopt patient-reported information via questionnaires completed online or on smartphones. The data could be transferred into the electronic health record, with doctors receiving alerts about symptoms that might warrant immediate medical attention.

“There’s nothing earth-shattering here. Patients already can call us when they have health concerns, although often they are hesitant to call the office or can’t get through,” Dr Basch explained. 

“What we want to do is switch this process over to an electronic format. It’s taking something we’ve been doing, and making it more efficient and systematic.”

Several major obstacles limit the adoption of patient self-reporting. Technologically, software applications that do collect patient data are usually challenging for patients to use.

“The companies that develop these electronic record systems have not been patient-centered in their approach, so it leaves the patient voice out,” Dr Basch said. 

“Some of them have developed some patient portal applications, but they’re very clunky, and the vast majority of patients do not use them at this point.”

A strong financial incentive for implementation of such a system does not exist.

“There needs to be a business model… It would save money, ultimately, because there would likely to be fewer ER visits, and outcomes would improve. It would make sense to pay for this because it adds value,” said Dr Basch.

Additional concerns around efficient implementation of monitoring of patient-reported symptoms remain.

“This is just one mechanism for monitoring people, but it could help us turn ‘patient-centered care’ into a reality,” said Dr Basch.


1. Basch E. Patient-reported outcomes – harnessing patients’ voices to improve clinical Care. N Engl J Med. 2017 Jan 12. doi: 10.1056/NEJMp1611252.