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Improving Patient Care

Cancer patients can use wireless personal computers to log their symptoms and this can bring about an improvement in patient care as well as move cancer research further along, say the authors of a study coming out of Duke Comprehensive Cancer Center. Amy Abernethy, M.D., lead investigator for the study and an oncologist at Duke University Medical Center said, "We wanted to see if patient-reported data generated at the point of care could be used to build a growing dataset for clinical care and research. We found that we could create a rapid learning oncology system in an academic clinic without interrupting patient care."

Immediate Report

For purposes of the study, the researchers collected data from 275 patients suffering from breast, lung, and gastrointestinal cancer. On days they were scheduled for appointments, patients were given wireless personal computer tablets on their arrival at the clinic. Patients were guided by the computers through a number of questions relating to their symptoms and quality of life. An immediate report was generated for clinic doctors to review. The computers also served to educate patients about their particular cancers.

Besides the immediate data provided to clinicians by their patients and the education information provided to the patients, the data collected helped clinicians better understand how to care for their oncology patients. This data also holds the potential to be useful for comparison with data from other clinics, should they follow suit. Patient interventions might benefit in great measure from an analysis of such patient data and patient care patterns might be identified and improved.

Patient Issues

Both patients and clinicians found the system advantageous, convenient, and pleasant to use. Abernethy explained the feeling of the research team that the study is an excellent model of what a "patient-centered learning health care system" is meant to be. It can be difficult or embarrassing for patients to describe their symptoms with frankness. The personal computers gave them an easier way of expressing their thoughts and helped remind them of symptoms developed since their prior appointments. Abernethy said the system also helped clinicians identify and address patient issues that developed over time and had not been given adequate attention up until now. An example of this was seen with breast cancer patients, who recorded worsening sexual distress. As clinicians noted the issue arising again and again with many patients, they developed interventions to address the problem. The researchers are scheduled to present their findings at a meeting of the American Society of Clinical Oncology, in Orlando, Fla, on Sunday, May 31, 2009.


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