Patients with either breast symptoms or newly diagnosed breast cancer who completed a Web-based survey prior to their first clinic visit were highly satisfied with the experience, an evaluation of the first-year of implementation has found.
“Technology will dramatically transform health care information transfer in the next decade,” reported E. Shelley Hwang, MD, MPH, of the University of California, San Francisco, California, and colleagues at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium. “This is an example of what clinicians will be doing all over the world.”
The investigators conducted the study to determine the feasibility, satisfaction, and challenges reported by patients related to the introduction of an electronic patient intake tool in an outpatient breast care clinic setting. The survey is quite long; the 200-plus questions focus on medical/family history, symptoms, and psychosocial well-being. The output for clinicians includes a narrative summary report as well as a body diagram of where the patient has indicated type of pain. Dr. Hwang said that if a patient reports smoking or marital abuse, for example, they can be referred for counseling. Here’s how the system works:
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1. The patient calls to schedule an appointment.
2. The scheduler enters the appointment into the system, generating an e-mail link to the patient for the survey.
3. The patient completes the survey at home via the Internet before her appointment.
4. If the patient does not have computer access, she is invited to use a touch screen tablet PC when she arrives for her appointment.
5. The coordinator prints the summary report on day of the clinic visit and attaches to the patient’s chart. The clinician reviews the summary report during the consultation.
During the first full year of the survey (2009), 1,218 women responded, 400 (30%) of whom were newly diagnosed with breast cancer and 106 (10%) with stage IV breast cancer. Most were aged 19 to 49 years (n = 508) or 50 to 69 years (n = 586).
Most patients (87%) completed the survey at home; 7% completed it in the office. Less than 5% reported an inability to access the Internet. Dr. Hwang said the survey takes about 45 minutes to complete.