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Sylvester Comprehensive Cancer Center develops electronic wellness check

June 14, 2022 – My Wellness Check, an electronic health record integrated with the symptom and practice needs screening and referral system developed at Sylvester Comprehensive Cancer Center, part of UHealth – University of Miami Health System, has been released online for all Sylvester outpatients and providers on June 1.

Sylvester researchers used and studied the My Wellness Check tool in preparation for system-wide rollout, which will now include not only Sylvester’s outpatient oncology clinics, but also Sylvester’s central campus. Ambulatory, or ambulatory, clinics are places where patients receive care, treatment, and follow-up visits after a cancer diagnosis. The Cancer Center has these satellite offices in South Florida, including specialty clinics for Breast Oncology, Gynecology, Hematology Oncology, General Oncology, Radiation Oncology, Surgical Oncology, surgical reconstruction, survival and supportive care.

My Wellness Check is available in English and Spanish and has been developed to assess a wide range of physical and emotional symptoms of cancer patients, such as pain, fatigue, anxiety and depression, as well as practical needs , including transportation, childcare and finances. concerns. The assessment is recorded in “real time” in the electronic health record, and patients are triaged to support services and/or medical teams during their visits.

“UHealth is the first health system to integrate (National Institutes of Health) Patient-Reported Outcome Measurement Information System (PROMIS) measures developed by NIH and well validated in Spanish to assess and monitor well -physical, emotional and social being,” said Frank J. Penedo, Ph.D., Sylvester’s associate director for cancer survivorship and translational behavioral sciences.

The rollout follows recently published research in JCO Oncology Practice, which documented the feasibility of using English and Spanish language screening measures in patients of various races and ethnicities.

Franck Penedo

Frank J. Penedo, Ph.D., Sylvester Associate Director for Cancer Survival and Translational Behavioral Sciences

Feasibility study including Spanish speakers

“Ours was the first large-scale study to assess the use of a patient-reported screening system integrated with the electronic health record among Spanish speakers, who have historically been excluded from such initiatives,” said Dr. Penedo. .

Dr. Penedo and Sylvester co-authors implemented the pilot project at the UHealth Gynecology-Oncology Outpatient Clinic. Of more than 1,200 assessments offered to patients from October 2019 to January 2021, 60% were initiated, including more than 65% in English and approximately 50% in Spanish. Of the 506 completed screenings, more than 50% were Hispanic or Latino. All were female, which the authors say may limit the generalizability of these findings to other patient populations.

Respond to patient needs and concerns

Most patients completed the 8-10 minute screening at home through the patient portal. Patients were most likely to express nutritional concerns or needs, followed by emotional symptoms, practical needs, and physical symptoms. The appropriate oncology healthcare professional treated physical symptoms in over 77% of cases; social work staff reacted to emotional symptoms in almost 100% of cases; and a dietitian followed patients with nutritional needs in nearly 79% of cases.

These findings are consistent with emerging evidence that patient-reported outcomes assessing the range of health and well-being issues in cancer patients and survivors can facilitate responsive, patient-centered care and improve patient-provider communication, according to Dr. Penedo.

Improving care for cancer patients and survivors

This type of screening is beginning to impact the lives of cancer patients and survivors at cancer centers across the country. It will inform future efforts on how to improve care with adequate representation from racial and ethnic minorities and, in Sylvester’s case, among Spanish speakers, according to Dr. Penedo.

“We are currently looking at long-term clinical outcomes, such as emergency room visits, hospitalizations and the impact of My Wellness Check on these outcomes. These results should be ready for publication soon,” said Dr. Penedo.

Co-authors of the JCO Oncology Practice paper include: Heidy N. Medina MPH, Ph.D. Candidate in Epidemiology in the Department of Public Health Sciences at the Miller School; Patricia I. Moreno, Ph.D., leader of evidence-based supportive care for survivors at Sylvester; Vandana Sookdeo, MD, MBA, administrative director of clinical survival programs at Sylvester; Akina Natori, MD; Cody Boland, MS, graduate student in psychology; Matthew P. Schlumbrecht, MD, co-medical director, clinical survivorship research programs at Sylvester; Carmen Calfa, MD, co-medical director, clinical survival programs at Sylvester; Jessica MacIntyre, APRN, NP-C, AOCNP, director of clinical operations at Sylvester; and Tracy E. Crane, Ph.D., director of lifestyle medicine and digital health at Sylvester.

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