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Improving the Patient Experience With a Radiation Oncology App

Nalley, Catlin

doi: 10.1097/01.COT.0000652324.62514.ce
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ORLANDO—Recognizing a gap in their patient education materials, the WellSpan Oncology Service Line developed a mobile app that offers radiation oncology patients on-demand access to treatment- and disease-specific education.

“We found that the materials being provided were very static and limited,” noted Bryan M. Schmalhofer, MBA RT(R)(T), Manager of Radiation Oncology Operations, WellSpan Health Oncology Service Line, WellSpan Cancer Centers. “Additionally, patients were typically receiving this information after the consultation.”

Schmalhofer, who spearheaded the development of this app, thought providing more comprehensive information earlier in the process would be beneficial. “If we could provide this information to patients before they came into the consultation process, they would be better prepared and it may help decrease their anxiety,” he said. “It would also facilitate a more collaborative environment for both patients and providers.”

This novel program was recognized during the Association of Community Cancer Centers (ACCC) 36th National Oncology Conference with an ACCC 2019 Innovator Award.

Key Features

The Rad Onc mobile app incorporates several features that provide support for patients throughout their treatment, including patient appointment and treatment schedules, a symptom tracker, access to support services, and more.

Through the app, patients have access to cancer-specific education materials and videos, integrated from rtanswers.org, that help them better understand and navigate the system. Additionally, a section with FAQs before, during, and after treatment is also available.

“We saw this as a tool to educate patients, but also as a way to allow them to become more involved in their own care,” noted Schmalhofer. “Remote symptom monitoring provides patients this opportunity, while ensuring that their health care needs are met.”

This feature allows patients to add their symptoms to the app as they occur and since the app is connected to WellSpan's EHR, clinicians can use the data to monitor patient symptoms and side effects. “As a result, we can intervene when needed and help our patients avoid the emergency room and additional complications,” Schmalhofer said.

Symptom monitoring through the app helps create a more accurate picture of a patient's health. During a doctor's visit, patients may not be able to recall every symptom that has arisen since their last appointment. “It can be very ambiguous,” according to Schmalhofer. “Whereas, patients that are involved in their care while they're at home can report a symptom in that moment, which provides a more objective view.”

Patients who report symptoms at a severity of seven or greater receive a pop-up that prompts them to contact their cancer center due to the severity of their symptoms. It provides all the information needed to reach an on-call physician after hours, weekends, and holidays. Google version is pending approval. Once approved, IOS and Google versions of the app will be implemented with this functionality.

Over the course of cancer treatment, the patient is faced with numerous appointments. Patients can keep track of their treatment visits through the app. Another way the app improves the patient experience is through push notifications. “If we are running behind, a staff member could send a notification to the patient letting them know they can come in a little later,” Schmalhofer said. “This eliminates unnecessary waiting and streamlines care for patients as well as providers.”

This app is also a useful tool for families and caregivers. “Through proxy access, we are able to provide information on the patient's schedule,” Schmalhofer noted. “They can also type their questions into the app. So, instead of relying on their family member to remember their question, they can open their app and the questions are right there.”

Ongoing Development

This is the first homegrown app for WellSpan and its development has been a learning process for the entire team.

“We didn't know what we didn't know going into this process,” Schmalhofer told Oncology Times. “We are continually learning more about what we can do with the app and looking for ways to further improve the patient experience.”

For instance, the team is working to build alerts into the system for the care team to be notified immediately when patients submit symptoms into the app. “The app continues to evolve as we take into consideration the expectations and needs of the patients and care team,” Schmalhofer said.

Another feature that Schmalhofer would like to see in the app is medication tracking. “The patient would have the ability to set their own reminders within the app,” he explained. “It would include all their prescriptions imported from the EHR and how often they needed to take it. It would also allow the care team to track their medication adherence.”

Schmalhofer and his colleagues would also like to include timed reminders for patients to report their symptoms. “We want to be as proactive as possible to help our patients,” he said. “This would increase compliance, which in turn would help avoid unnecessary hospitalizations.”

The WellSpan team would also like to eventually add other resources, including financial advocacy and psychosocial support. “Looking at care from a patient-centric point of view is what this app is all about,” Schmalhofer emphasized. “We are focused on improving the whole experience, from education to communication. This is vital for our patients, who are undergoing what is probably the worst time in their life.”

In an effort to ensure as many patients as possible have access to these resources, a desktop or progressive web version of the app is currently in development. “This will be a good option for older patients who may not have a smart phone,” Schmalhofer explained. “Also, our patient population includes Plain Communities. While they don't use phones, they may go to a library or neighbor's house to use the computer. We want to ensure these resources are available to everyone.”

Building Connections

Beyond the various features, the app serves as a means to connect the patients with their health care team.

“As a treating therapist, as well as going through cancer treatments with my father and brother, I was able to see firsthand what was lacking for patients and families,” Schmalhofer recalled. “And, I recognized this app as an opportunity for our patients to be able to build a deeper connection with the care staff.”

Staff members have the opportunity to build personalized bios for the patients to view within the app. “This can help patients learn more about the individuals providing their care and build connections through shared interests,” he said. “I wanted to tailor the patient experience, making it easier for both patients and staff. When our patients finish their treatment, what they remember most are the connections they made with their health care team.

“As Maya Angelou once said, ‘I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.’”

This app is a valuable tool for both patients and providers that can make a difference across the care continuum. It is also an example of the power of out-of-the-box thinking. And Schmalhofer is happy to share his insights with fellow health care systems.

“Do you know what we're here for? We're here to do everything we can to help patients,” he concluded. “We have the technology now that can help us do that. You just have to figure out how to make it work sometimes. Making it work, would not have been possible without the immense support and vision of WellSpan's senior leadership and IT department.”

Catlin Nalley is a contributing writer.

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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