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SymptomCare@Home: Developing an Integrated Symptom Monitoring and Management System for Outpatients Receiving Chemotherapy

Beck, Susan L. PhD, APRN, FAAN; Eaton, Linda H. PhD, RN, AOCN; Echeverria, Christina MS; Mooney, Kathi H. PhD, RN, FAAN

CIN: Computers, Informatics, Nursing: October 2017 - Volume 35 - Issue 10 - p 520–529
doi: 10.1097/CIN.0000000000000364
Features

SymptomCare@Home, an integrated symptom monitoring and management system, was designed as part of randomized clinical trials to help patients with cancer who receive chemotherapy in ambulatory clinics and often experience significant symptoms at home. An iterative design process was informed by chronic disease management theory and features of assessment and clinical decision support systems used in other diseases. Key stakeholders participated in the design process: nurse scientists, clinical experts, bioinformatics experts, and computer programmers. Especially important was input from end users, patients, and nurse practitioners participating in a series of studies testing the system. The system includes both a patient and clinician interface and fully integrates two electronic subsystems: a telephone computer-linked interactive voice response system and a Web-based Decision Support–Symptom Management System. Key features include (1) daily symptom monitoring, (2) self-management coaching, (3) alerting, and (4) nurse practitioner follow-up. The nurse practitioner is distinctively positioned to provide assessment, education, support, and pharmacologic and nonpharmacologic interventions to intensify management of poorly controlled symptoms at home. SymptomCare@Home is a model for providing telehealth. The system facilitates using evidence-based guidelines as part of a comprehensive symptom management approach. The design process and system features can be applied to other diseases and conditions.

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Author Affiliations: College of Nursing and Huntsman Cancer Institute, University of Utah, Salt Lake City (Drs Beck and Mooney); University of Washington of Nursing, Seattle, WA (Dr Eaton); and College of Nursing, University of Utah, Salt Lake City (Ms Echeverria).

This work was supported by research grants from the National Cancer Institute of National Institutes of Health (R01 CA89474 and R01 CA120558 to K.H.M., S.L.B., C.E.). The effort of L.H.E. was supported (in part) by the National Institute of Nursing Research of the National Institutes of Health under award T32NR013456.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Corresponding author: Susan L. Beck, PhD, APRN, FAAN, College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT 84112 (susan.beck@nurs.utah.edu).

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