Pre-implementation of electronic patient-reported outcomes at reference centers for head and neck oncology. A roadmap towards patient-centered digitalization

Background: Electronically captured patient reports (electronic patient-reported outcomes, ePROs) are digital questionnaires filled out by cancer patients. Despite indications of improved clinical care, the integration of ePROs into clinical head and neck oncology is uncharted territory. Objective: This work outlines the implementation process for ePROs at the University Hospital for Otorhinolaryngology at the Medical University of Innsbruck (ENT Innsbruck). Methods: The implementation is carried out by a project team in a pre-implementation phase (needs assessment, implementation planning, identification of intra-hospital barriers, prototype development, testing and adaptation, and user training), an implementation phase (implementation and user training), and a post-implementation phase (quality control and project expansion). Results: The project team at ENT Innsbruck, consisting of 10 members, identified the need for digitalization in cancer follow-up. A hybrid implementation solution (Computer-Based Health Evaluation System, CHES; Evaluation Software Development, ESD, Innsbruck, Austria) was chosen. ePROs (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - 30 items, EORTC-QLQ-C30; Head and Neck Functional Integrity Scale, HNC-FIT scale; and EORTC Head and Neck Cancer Module, EORTC H&N43) will be collected 12 times over 5.5 years. A total of 25 users rated the prototype as user friendly (patient perspective: 8.1 +/- 1.6, 3-10; user perspective: 8.6 +/- 1.1, 6-10). The main advantage was faster medical history taking (72%), and the main disadvantages were a lack of personnel, time, and motivation (52%). Conclusion: The feedback on the ePRO prototype at ENT Innsbruck was positive. The implementation phase commenced in the first quarter of 2024. Goal achievement will be evaluated in the post-implementation phase in the fourth quarter of 2024.