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.

Case report: dynamic personalized physiological monitoring in lung cancer using wearable data.

Pretreatment prognostication, on-treatment monitoring, and early detection of physiological symptoms are considerable challenges in cancer. We describe the feasibility of high-resolution wearable data (steps per day, walking speed) to longitudinally profile physiological trajectories extracted from Apple Health data in three patients with lung cancer from diagnosis through cancer treatment after obtaining informed consent. We used descriptive statistics to describe our approach of building longitudinal physiological profiles.

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.

A Framework for Integrating Telehealth Equitably across the cancer care continuum.

The COVID-19 pandemic placed a spotlight on the potential to dramatically increase the use of telehealth across the cancer care continuum, but whether and how telehealth can be implemented in practice in ways that reduce, rather than exacerbate, inequities are largely unknown. To help fill this critical gap in research and practice, we developed the Framework for Integrating Telehealth Equitably (FITE), a process and evaluation model designed to help guide equitable integration of telehealth into practice. In this manuscript, we present FITE and showcase how investigators across the National Cancer Institute's Telehealth Research Centers of Excellence are applying the framework in different ways to advance digital and health equity.

Identifying Nonpatient Authors of Patient Portal Secure Messages in Oncology: A Proof-of-Concept Demonstration of Natural Language Processing Methods.

Purpose: Patient portal secure messages are not always authored by the patient account holder. Understanding who authored the message is particularly important in an oncology setting where symptom reporting is crucial to patient treatment. Natural language processing has the potential to detect messages not authored by the patient automatically.

Managing Critical Patient-Reported Outcome Measures in Oncology Settings: System Development and Retrospective Study.

Background: Remote monitoring programs based on the collection of patient-reported outcome (PRO) data are being increasingly adopted in oncology practices. Although PROs are a great source of patient data, the management of critical PRO data is not discussed in detail in the literature.

Objective: This first-of-its-kind study aimed to design, describe, and evaluate a closed-loop alerting and communication system focused on managing PRO-related alerts in cancer care.

Ethics Consultation Requests After Implementation of an Electronic Health Record Order.

Purpose: As the role of clinical ethics consultation in health care advances, there are calls to standardize the process of consultation. The Ethics Committee at Memorial Sloan Kettering Cancer Center (MSK) hypothesized that the process of requesting an ethics consultation could be improved by instituting an electronic health record (EHR) order for consultation requests. This report summarizes the impact of adopting an EHR order for ethics consultation requests at MSK.

Adoption of Patient-Generated Health Data in Oncology: A Report From the NCCN EHR Oncology Advisory Group.

Background: Collecting, monitoring, and responding to patient-generated health data (PGHD) are associated with improved quality of life and patient satisfaction, and possibly with improved patient survival in oncology. However, the current state of adoption, types of PGHD collected, and degree of integration into electronic health records (EHRs) is unknown.

Methods: The NCCN EHR Oncology Advisory Group formed a Patient-Reported Outcomes (PRO) Workgroup to perform an assessment and provide recommendations for cancer centers, researchers, and EHR vendors to advance the collection and use of PGHD in oncology.

Preferences in Oncology History Documentation Styles Among Clinical Practitioners.

Purpose: Clinical notes function as the de facto handoff between providers and assume great importance during unplanned medical encounters. An organized and thorough oncology history is essential in care coordination. We sought to understand reader preferences for oncology history organization by comparing between chronologic and narrative formats.

A Randomized Controlled Trial Evaluating Electronic Outpatient Symptom Monitoring After Ambulatory Cancer Surgery.

Objective: We implemented routine daily electronic monitoring of patient-reported outcomes (PROs) for 10 days after discharge after ambulatory cancer surgery, with alerts to clinical staff for worrying symptoms. We sought to determine whether enhancing this monitoring by adding immediate automated normative feedback to patients regarding expected symptoms would further improve the patient experience.

Summary Of Background Data: PRO monitoring reduces symptom severity in cancer patients.

Interfaces for collecting data from patients: 10 golden rules.

Memorial Sloan Kettering Cancer Center has more than a decade's experience creating online interfaces for obtaining data from patients as part of routine clinical care. We have developed a set of "golden rules" for design of these interfaces. Many relate to the knowledge imbalance between professional staff (whether medical or informatics) and patients, who are often old and sick and have limited knowledge of technology.

Ambulatory cancer care electronic symptom self-reporting (ACCESS) for surgical patients: a randomised controlled trial protocol.

Introduction: An increasing proportion of cancer surgeries are ambulatory procedures requiring a stay of 1 day or less in the hospital. Providing patients and their caregivers with ongoing, real-time support after discharge aids delivery of high-quality postoperative care in this new healthcare environment. Despite abundant evidence that patient self-reporting of symptoms improves quality of care, the most effective way to monitor and manage this self-reported information is not known.

Real-World Outcomes of an Automated Physician Support System for Genome-Driven Oncology.

Purpose: Matching patients to investigational therapies requires new tools to support physician decision making. We designed and implemented Precision Insight Support Engine (PRECISE), an automated, just-in-time, clinical-grade informatics platform to identify and dynamically track patients on the basis of molecular and clinical criteria. Real-world use of this tool was analyzed to determine whether PRECISE facilitated enrollment to early-phase, genome-driven trials.

Informing, Reassuring, or Alarming? Balancing Patient Needs in the Development of a Postsurgical Symptom Reporting System in Cancer.

After ambulatory surgeries, patients who recover at home have multiple questions about wound healing, symptoms and medication side effects, and recovery expectations. We conducted user testing and rapid application development of a newly developed symptom reporting system that supports home-based recovery by inviting patients to self-report symptoms in the days after surgery and then receive an immediate feedback report giving context for their reported symptoms. Findings showed that some participants primarily valued reassurance, whereas others prioritized receiving alerts about potential problems.

Autonomous detection, grading, and reporting of postoperative complications using natural language processing.

Introduction: Natural language processing, a computer science technique that allows interpretation of narrative text, is infrequently used to identify surgical complications. We designed a natural language processing algorithm to identify and grade the severity of deep venous thrombosis and pulmonary embolism (together: venous thromboembolism).

Methods: Patients from our 2011-2014 American College of Surgeons National Surgical Quality Improvement Project cohorts with a duplex ultrasound or a computerized tomography angiography of the chest performed within 30 days of surgery were divided into training and validation datasets.

Natural Language Processing-Enabled and Conventional Data Capture Methods for Input to Electronic Health Records: A Comparative Usability Study.

Background: The process of documentation in electronic health records (EHRs) is known to be time consuming, inefficient, and cumbersome. The use of dictation coupled with manual transcription has become an increasingly common practice. In recent years, natural language processing (NLP)-enabled data capture has become a viable alternative for data entry.

Automated eligibility screening and monitoring for genotype-driven precision oncology trials.

The Information Systems Department at Memorial Sloan Kettering Cancer Center developed the DARWIN Cohort Management System (DCMS). The DCMS identifies and tracks cohorts of patients based on genotypic and clinical data. It assists researchers and treating physicians in enrolling patients to genotype-matched IRB-approved clinical trials.

Implementation of a computerized patient handoff application.

For hospitalized patients, handoffs between providers affect continuity of care and increase the risk of medical errors. Most commercial electronic health record (EHR) systems lack dedicated tools to support patient handoff activities. We developed a collaborative application supporting patient handoff that is fully integrated with our commercial EHR.