Waiting to Exhale: The Feasibility and Appropriateness of Home Blood Oxygen Monitoring in Oncology Patients Post-Hospital Discharge.

Purpose: Pulse oximetry remote patient monitoring (RPM) post-hospital discharge increased during the COVID-19 pandemic as patients and providers sought to limit in-person encounters and provide more care in the home. However, there is limited evidence on the feasibility and appropriateness of pulse oximetry RPM in patients with cancer after hospital discharge.

Methods And Materials: This feasibility study enrolled oncology patients discharged after an unexpected admission at the Memorial Sloan Kettering Cancer Center from October 2020 to July 2021.

Perspectives on Telemedicine Visits Reported by Patients With Cancer.

Importance: The COVID-19 pandemic catalyzed rapid adoption of telemedicine visits for cancer care delivery. However, patients' experiences with telemedicine remain poorly understood.

Objective: To understand patients' satisfaction with telemedicine visits at a comprehensive cancer center.

Oncology Clinicians' Perspectives of a Remote Patient Monitoring Program: A Multi-Modal Case Study Approach.

Background: Remote patient monitoring (RPM) aims to improve patient access to care and communication with clinical providers. Overall, understanding the usability of RPM applications and their influence on clinical care workflows is limited from the perspectives of clinician end users at a cancer center in the Northeast, United States.

Objective: Explore the usability and functionality of RPM and elicit the perceptions and experiences of oncology clinicians using RPM for oncology patients after hospital discharge.

The Large Language Model GPT-4 Compared to Endocrinologist Responses on Initial Choice of Antidiabetic Medication under Conditions of Clinical Uncertainty.

Objective: To explore how the commercially available large language model (LLM) GPT-4 compares to endocrinologists when addressing medical questions when there is uncertainty regarding the best answer.

Research Design And Methods: This study compared responses from GPT-4 to responses from 31 endocrinologists using hypothetical clinical vignettes focused on diabetes, specifically examining the prescription of metformin versus alternative treatments. The primary outcome was the choice between metformin and other treatments.

Transforming patient-centered cancer care using telehealth: the MATCHES Center.

Modern cancer care is costly and logistically burdensome for patients and their families despite an expansion of technology and medical advances that create the opportunity for novel approaches to care. Therefore, there is a growing appreciation for the need to leverage these innovations to make cancer care more patient centered and convenient. The Memorial Sloan Kettering Making Telehealth Delivery of Cancer Care at Home Efficient and Safe Telehealth Research Center is a National Cancer Institute-designated and funded Telehealth Research Center of Excellence poised to generate the evidence necessary to inform the appropriate use of telehealth as a strategy to improve access to cancer services that are convenient for patients.

Opportunities and Challenges for Augmented Reality in Family Caregiving: Qualitative Video Elicitation Study.

Background: Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home.

Digitally Enabled Transitional Care Management in Oncology.

Purpose: Improving care transitions for patients with cancer discharged from the hospital is considered an important component of quality care. Digital monitoring has the potential to better the delivery of transitional care through improved patient-provider communication and enhanced symptom management. However, remote patient monitoring (RPM) interventions have not been widely implemented for oncology patients after discharge, an innovative setting in which to apply this technology.

Telemedicine and Cancer Care: Barriers and Strategies to Optimize Delivery.

Telemedicine holds the potential to transform cancer care delivery and optimize value, access, and quality of care. A transformed regulatory environment coupled with the need to continue medical care despite operational limitations led to the rapid expansion of telemedicine in cancer care during the COVID-19 pandemic. Its utilization has since varied, and it has faced significant challenges.

Electronic consent in clinical care: an international scoping review.

Objective: Digital technologies create opportunities for improvement of consenting processes in clinical care. Yet little is known about the prevalence, characteristics or outcomes of shifting from paper to electronic consenting, or e-consent, in clinical settings. Thus questions remain around e-consent's impact on efficiency, data integrity, user experience, care access, equity and quality.

Electronic Consent at US Cancer Centers: A Survey of Practices, Challenges, and Opportunities.

Purpose: Digital technologies create opportunities for improving consenting processes in cancer care and research. Yet, little is known about the prevalence of electronic consenting, or e-consent, at US cancer care institutions.

Methods: We surveyed institutions in the National Comprehensive Cancer Network about their capabilities for clinical, research, and administrative e-consents; technologies used; telemedicine consents; multilingual support; evaluations; and opportunities and challenges in moving from paper-based to electronic processes.

Digitalizing the Clinical Research Informed Consent Process: Assessing the Participant Experience in Comparison With Traditional Paper-Based Methods.

Purpose: Consent processes are critical for clinical care and research and may benefit from incorporating digital strategies. We compared an electronic informed consent (eIC) option to paper consent across four outcomes: (1) technology burden, (2) protocol comprehension, (3) participant agency (ability to self-advocate), and (4) completion of required document fields.

Methods: We assessed participant experience with eIC processes compared with traditional paper-based consenting using surveys and compared completeness of required fields, over 3 years (2019-2021).

Analysis of a Remote Monitoring Program for Symptoms Among Adults With Cancer Receiving Antineoplastic Therapy.

Importance: Electronic patient-reported outcomes (ePROs) may have the potential to improve cancer care delivery by enhancing patient quality of life, reducing acute care visits, and extending overall survival. However, the optimal cadence of ePRO assessments is unknown.

Objective: To determine patient response preferences and the clinical value associated with a daily cadence for ePROs for patients receiving antineoplastic treatment.

ChemoPalRx-A Mobile App That Enhances Chemotherapy Prescription Accuracy: A Cross-Sectional Study.

Purpose: ChemoPalRx is a novel provider order entry mobile application for chemotherapy. This study aims to evaluate the accuracy of prescribing chemotherapy using ChemoPalRx versus handwritten orders at a safety-net hospital in Los Angeles.

Methods: In a cross-sectional study from October 2019 to December 2019, we evaluated all outpatient chemotherapy orders for accuracy.

Applying User-Centered Design in the Electronic Health Record (EHR) to Facilitate Patient-Centered Care in Oncology.

Patient-centered care is an essential component of quality health care. To support patient-centered care initiatives at our institution, we created a feature in our EHR to centrally view information about the patient's values, goals and preferences. We applied user-centered design methods to ensure that the aggregate view was easy to use and would meet user needs.

A Novel Patient Values Tab for the Electronic Health Record: A User-Centered Design Approach.

Background: The COVID-19 pandemic has shined a harsh light on a critical deficiency in our health care system: our inability to access important information about patients' values, goals, and preferences in the electronic health record (EHR). At Memorial Sloan Kettering Cancer Center (MSK), we have integrated and systematized health-related values discussions led by oncology nurses for newly diagnosed cancer patients as part of routine comprehensive cancer care. Such conversations include not only the patient's wishes for care at the end of life but also more holistic personal values, including sources of strength, concerns, hopes, and their definition of an acceptable quality of life.

Needs and Perspectives of Cancer Center Stakeholders for Access to Patient Values in the Electronic Health Record.

Purpose: High-quality cancer care must incorporate patients' personal values in decision making throughout illness. Unfortunately, patient values are neither consistently elicited nor easily accessible in the electronic health record (EHR). Memorial Sloan Kettering Cancer Center is deploying a major EHR innovation, called the Patient Values Tab, which provides ready access to patients' values and personhood.

InSight Care Pilot Program: Redefining Seeing a Patient.

Purpose: Early detection and management of symptoms in patients with cancer improves outcomes. However, the optimal approach to symptom monitoring and management is unknown. InSight Care is a mobile health intervention that captures symptom data and facilitates patient-provider communication to mitigate symptom escalation.

A new approach to integrating patient-generated data with expert knowledge for personalized goal setting: A pilot study.

Introduction: Self-monitoring technologies produce patient-generated data that could be leveraged to personalize nutritional goal setting to improve population health; however, most computational approaches are limited when applied to individual-level personalization with sparse and irregular self-monitoring data. We applied informatics methods from expert suggestion systems to a challenging clinical problem: generating personalized nutrition goals from patient-generated diet and blood glucose data.

Materials And Methods: We applied qualitative process coding and decision tree modeling to understand how registered dietitians translate patient-generated data into recommendations for dietary self-management of diabetes (i.

Interrupting providers with clinical decision support to improve care for heart failure.

Background: Evidence-based therapy for heart failure remains underutilized at hospital discharge, particularly for patients with heart failure who are hospitalized for another cause. We developed clinical decision support (CDS) to recommend an angiotensin converting enzyme (ACE) inhibitor during hospitalization to promote its continuation at discharge. The CDS was designed to be implemented in both interruptive and non-interruptive versions.

Interruptive Versus Noninterruptive Clinical Decision Support: Usability Study.

Background: Clinical decision support (CDS) has been shown to improve compliance with evidence-based care, but its impact is often diminished because of issues such as poor usability, insufficient integration into workflow, and alert fatigue. Noninterruptive CDS may be less subject to alert fatigue, but there has been little assessment of its usability.

Objective: This study aimed to study the usability of interruptive and noninterruptive versions of a CDS.