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    Augmenting Outpatient Care: The CPROR Review Highlights the Transformative Impact of ePROs

    The researchers of the Centre for Patient-Reported Outcomes Research (CPROR), at the University of Birmingham, have recently studied the use of electronic patient-reported outcomes (ePRO) systems in assessing clinical care. The review was published in the Journal of the Royal Society of Medicine. It reported significant benefits of implementing digital health technologies (DHTs), such as PRO-based remote symptom monitoring tools, in clinical studies. According to the review findings, clinical studies that use ePRO to triage patient care see augmented clinical practice and a considerable decrease in the number of outpatient waiting lists.  

    With that said, the global demand for healthcare has already transcended capacity. The increasing crisis in the healthcare sector was further exacerbated by COVID-19. The pandemic led to longer patient waits and an increase in backlogs. Amidst this situation, implementing high-end ePROs, such as ObvioHealth, stands as a strategic imperative for healthcare providers and trial sponsors. ePRO allows participants to fill up questionnaires from the comfort of their homes. By providing proactive patient experiences, it ultimately enhances patient recruitment and retention rates.

    In addition, it enables clinicians to access near real-time health outcomes reported by the participants. The result is accelerated and streamlined remote data collection and remote patient monitoring. These helps healthcare providers manage the surging healthcare demand better. This way, it brings about more effective and improved patient care.

    The review includes studies on various patient groups. This allowed it to examine the potential impact and effectiveness of remote symptom reporting systems in various clinical specialities. According to the review, the inclusion of patients with clinical conditions, such as HIV, cancer, epilepsy, sleep apnea, rheumatoid arthritis (RA), and type 1 diabetes, delivers in-depth insights into the efficacy of ePRO across different healthcare settings.

    Administering ePRO for outpatient care offers a slew of benefits, as reported in the study. Triaging patients efficiently and assessing their clinical needs allows healthcare providers to provide more tailored patient management. For example, patients with stable clinical conditions can be provided with essential remote symptom support. On the other hand, those with critical symptoms can be efficiently determined and prioritised.

    Furthermore, this remote approach allows for the timely delivery of interventions on demand. As a result, patients can access emergency healthcare faster. Besides ensuring streamlined and tailored healthcare, ePRO also helps optimise resource allocation. The result is a more efficient and effective outpatient system that doesn’t burden the participants and the caregivers, claims the report.

    The results of the studies on the aforementioned clinical specialities have been quoted in the review to back these findings. 

    For example, in a multi-centre, observational implementation study, AmbuFlex, a generic ePRO system, was used. Here, the outcomes reported by patients determined the need for an outpatient consultation. The study was conducted on over 40,000 outpatients with chronic conditions such as RA, epilepsy, asthma, narcolepsy, coronary heart disease, sleep apnoea, renal failure, prostate cancer, and colorectal cancer.

    According to the CPROR review, AmbuFlex significantly reduced the need for outpatient appointments. For example, for patients with sleep apnoea, the system led to a reduction of up to 57% in in-person consultation, while the reduction was of up to 48% for epilepsy outpatients.

    Lead author Dr Lee Aiyegbusi, Associate Professor and Deputy Director at CPROR, said: “The use of PROs is well established in research settings to evaluate the effectiveness, cost-effectiveness and tolerability of interventions from a patient perspective. Clinicians are now interested in using patient-level symptom reporting for the clinical management of individual patients in routine practice.”

    “ePROs for outpatient care could facilitate the tailoring of care to patient needs. Stable patients can be monitored remotely using ePROs, thereby avoiding unnecessary check-ups in outpatient clinics and associated costs, such as travel and time off work, without lowering the quality of treatment.

    “This efficient use of scarce healthcare resources could free up outpatient clinics for patients with high symptom burden or concerning symptoms, so they can be seen more quickly.”

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