EHR-integrated questionnaires in colorectal surgery: would patients accept this as standard of care?
Ming Cai, Sandra L. Wong, Sara W. Mayo*
Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
Objective: To examine the relationship between baseline patient-reported bowel function and postoperative symptom reporting among patients undergoing surgery for colorectal cancer.
Design: Retrospective cohort study.
Setting: Academic quaternary care referral center.
Patients: Patients who underwent major abdominal surgery for colorectal cancer at a single institution were included.
Interventions: Preoperative bowel function was assessed using the validated Colorectal Functional Outcome (COREFO) questionnaire. A score greater than 15 is considered symptomatic. Postoperatively, patients with access to the patient portal received automated prompts for electronic patient reported outcomes questionnaires via an EHR-integrated platform (eSyM) after discharge.
Main Outcome Measure(s): Utilization of eSyM postoperatively and frequency of severe symptom reporting.
Results: 168 patients meeting the inclusion criteria underwent surgery between April 2020-June 2022 (median age 65.0, 46.4% female). 148 completed COREFO questionnaires preoperatively; 54 (36.5%) had scores >15. Of the 108 patients with electronic portal access, 67.6% used eSyM postoperatively. Among eSyM users, 72.3% (47 of 73) reported severe symptoms with an average of 7.5 questionnaires completed (Figure 1). Those with COREFO>15 scores were more likely to use eSyM (80.0% vs 62.7%) though this difference was not significant (p=0.079).
Conclusions: Severe symptoms were more common in this colorectal cancer cohort than previously reported for thoracic and gynecologic cancer patients. Regardless of preoperative baseline bowel function, utilization of eSyM was high. This suggests that eSyM is an effective way for patients to communicate with their care teams in a postsurgical setting and may be especially helpful in colorectal surgery patients who require close attention and follow-up.
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