Comprehensive bio psychosocial screening, which covers not only physical symptoms and psychosocial issues, but also practical concerns such as transportation, finances, work and childcare, offers the true opportunity to maximize the benefits of medical care and social support to patients and their families while enhancing operational efficiency and resource management for healthcare organizations because of the identification and effective management of the bio psychosocial elements of cancer care. The early identification of patient problems is essential to manage distress, prevent crises, minimize system disruption, and reduce the costs of health care. There may be also added benefits related to patient, family and health care staff satisfaction as a result of enhanced communications and better care coordination. The overarching goal of PatientCareAnywhere as a patient-centered adaptive supportive care system is to improve patient outcomes for cancer patients while reducing healthcare costs. PatientCareAnywhere will be a patient empowerment solution to promote internal resilience and self-efficacy by creating new partnerships with patients and health care professionals across the care continuum: 1) geographically (home-hospital-community-home) and 2) medically (diagnosis-treatment-survivorship-death). Such support will be adaptive to individual's needs and health status based on comprehensive bio psychosocial screening and coordinated across multiple sources in the forms of referrals, education, engagement of community resources, and secure social communication. This project is based on the partnership between Bright Outcome and City of Hope (COH). PatientCareAnywhere will be derived from two existing systems, COH's Support Screen and Bright Outcome's MyCaringCircle, which share the same vision and are complementary in their approaches. Support Screen focuses on supportive care initiated from clinic-based encounters and MyCaringCircle is a home/community-based patient portal solution. Together, these two systems can provide comprehensive bio psychosocial screening and supportive care to patients across home to hospital settings and across the continuum of cancer care adaptively. This is a Fast-Track project. Phase I aims are to: 1) Collect input from 100 stakeholders on expected system features, perceived usefulness and impacts, and potential adoption barriers via focus groups; 2) Design and develop the prototype PatientCareAnywhere by leveraging support Screen and MyCaringCircle and by adapting the patient education materials from COH; 3) Conduct two usability tests with 24 subjects each and a pilot study with 50 subjects. Phase II aims are to: 1) Enhance and refine Phase I prototype based on Phase I evaluation feedback and expand disease stage and treatment modality support coverage; and 2) Conduct a randomized controlled trial with 516 patient subjects to confirm our study hypotheses of achieving better patient outcomes, better self-efficacy, and more cost-effective health service utilization with PatientCareAnywhere as compared to usual care.
The prevalence of psychological distress for cancer patients has been estimated to be approximately between 35% and 50%. Effective bio psychosocial screening integrated with triage, referrals, patient and caregiver education and follow-up, promotes successful patient-centered care across the cancer treatment trajectory. Studies have demonstrated that adequate integration of bio psychosocial screening with the provision of supportive care could result in better patient outcomes, better patient-provider communication, and higher patient satisfaction, detection of unrecognized problems, improved referrals, and better health service utilization/lower cost. Distress screening and management have thus been incorporated into treatment guidelines and accreditation standards. Our goal is thus to develop a patient empowerment solution, PatientCareAnywhere, as a patient-centered adaptive supportive care system to improve patient outcomes for cancer patients while reducing healthcare costs.