Our long-term objective is to develop a computer system facilitating the use of patient-reported outcomes (PRO) information to monitor patient status and assist clinical decision making for cancer patients under palliative and hospice care. This system will integrate PRO and other clinical data with evidence-based treatment guidelines and pathways to care and interface with and foster collaborative decision making between the patient, caregivers, and the medical care team. This project will leverage the Adapteval architecture for PRO management developed in our other SBIR efforts, already implementing CAT/IRT capability, multiple delivery platforms, graphical reports highlighting clinically meaningful PRO score changes, alert/reminder mechanisms, and CCOW-compliant integration. Considering the project goals and our past and current R&D efforts, we define the specific Phase I technical objectives as follows: 1) define a palliative/hospice care model to integrate PRO assessment results with evidence-based pathways to provide clinical decision support for clinicians and education opportunities for patients and caregivers via literature review, focus groups, and interviews; 2) design a system architecture facilitating the sharing the transfer of PRO-related medical data between cancer clinics, hospices, and patients' homes; 3) develop a working prototype following object-oriented and knowledge-based software development methodologies; and 4) evaluate the usability and usefulness of the prototype solution via controlled pilot tests. It is expected that Phase I results will validate the feasibility of the proposed solution from the perspectives of both practicality and technology for the purpose of Phase II execution and ultimate commercialization.
