Original Title: Sistemas de e-salud para el apoyo a pacientes oncológicos: propuesta de diseño para futuros estudios evaluativos

Authors' objectives: To develop a proposal to design studies on e-health systems that support cancer patients during chemotherapy treatment, in order to assess the feasibility, safety, clinical effectiveness and acceptance of such systems. To carry out a first approach to the assessment study.

Authors' results and conclusions: In the present report, we carried out a proposal for designing and assessing studies on e-health systems aimed at supporting cancer patients. The ONCOMED e-health system was installed within the Donostia University Hospital (DUH) network and the e-health system was integrated with other patient management systems already available within the hospital’s Information System (CITOS and HIS). The results of the technical pilot study show that the ONCOMED system is robust, secure and easy to maintain. No relevant technical problems were reported during the pilot study. Users stated that the tool was easy to use, the design was suitable and adequate support was provided for correct interaction with the system. ONCOMED acceptance by users was positive. The oncology patient reported feeling reassured and safe when using the ehealth system. Based on the results of the SWOT analysis, the most important strengths of the ONCOMED system were the ability to create a report containing patients’ clinical information and the fact that patients felt more secure and protected during oral chemotherapy treatment when using ONCOMED. The main weaknesses of the system included the need for clinical leadership and the involvement of health professionals. The main opportunity provided by the e-health system under study was the possibility of integration with other patient management systems. Finally, the identified threats were the resistance of health professionals to change, the lack of institutional support and the need for financial resources. DISCUSSION Although there are numerous native applications (apps) for supporting cancer patients, none have been assessed and, therefore, the evidence of their usefulness, effectiveness and safety is lacking. This report aims to provide guidelines for developing future assessment studies on applications designed to monitor the symptoms associated with chemotherapy. The document includes a reflection on the various key issues that have been identified during the incorporation of the ONCOMED e-health system, namely the integration of the patient support tool with other patient management systems, the organisational impact, improvements in communication between patients and healthcare providers, improvements in the coordination between levels of care, the importance of the intermediary of technology, the accuracy of the information contained in the apps, and the safeguard of the security and privacy of patients’ data. A discussion about the main weaknesses identified in the SWOT analysis is also included in the report. Finally, a checklist was proposed to guide a suggested sequence of actions for implementing assessment studies on e-health systems in the field of oncology. CONCLUSIONS This report aims to provide guidelines for future assessment studies on e-health applications in the field of medical oncology. This modest contribution could support the generation of scientific evidence on the usefulness, effectiveness and safety of new technologies similar to the one presented in this study in future.

Authors' methods: In this report a proposed methodology for conducting future assessment studies on e-health systems related to oncology is presented. As a first step, the development a pilot randomised trial with two follow-up groups is proposed. The control group would receive routine monitoring during oral chemotherapy treatment and the intervention group will receive support from the teleoncology system, in addition to routine follow-up. The intervention will involve the completion of a questionnaire to assess the toxicity caused by the chemotherapy treatment, using the e-health system through Smartphones or PCs. Patients will complete the questionnaire in two stated time slots when they present symptoms. The system will assess the severity and progression of symptoms described by the patient and will generate a series of alerts that will result in a health advice or phone calls to the patient. The primary outcome measure will be the feasibility of using the e-health system as a support tool for cancer patients receiving chemotherapy treatment. Secondary outcome measures include: the magnitude of the effect of using the teleoncology system on QoL, adequacy of the EORTC QLQ-C30 questionnaire for assessing the QoL, toxicity control, impact on health services usage, cost analysis and acceptance of the new e-health service by patients and healthcare professionals. The pilot study proposed in this report would be followed by a randomised controlled trial (RCT) which would allow the assessment of the effectiveness of the e-health system. In addition to the proposed methodology for the assessment of e-health systems in oncology, a one-week technical pilot study was conducted in order to assess the performance, usability and acceptability of the ONCOMED tool. The pilot study was performed on one breast cancer patient who was receiving Xeloda® (capecitabine) treatment and a nurse acting as case manager. A SWOT (strengths, weaknesses, opportunities and threats) analysis was also performed in order to evaluate the potential of the ONCOMED e-health system and provide recommendations on the use of the new technology.

Project Status: Completed

Year Published: 2015

URL for published report: https://www.ogasun.ejgv.euskadi.eus/r51-catpub/es/k75aWebPublicacionesWar/k75aObtenerPublicacionDigitalServlet?R01HNoPortal=true&N_LIBR=051726&N_EDIC=0001&C_IDIOM=es&FORMATO=.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government</p>