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J Am Med Inform Assoc 2008;15:679-686 doi:10.1197/jamia.M2532
  • Original Investigation
  • Model Formulation

Development and Implementation of a Clinician Reporting System for Advanced Stage Cancer: Initial Lessons Learned

  1. Lori L DuBenske,
  2. Ming-Yuan Chih,
  3. Susan Dinauer,
  4. David H Gustafson,
  5. James F Cleary
  1. Center for Health Enhancement Systems Studies, University of Wisconsin, Madison Wisconsin
  1. Correspondence: Lori L. DuBenske, Ph.D., 1513 University Avenue, Room 4105, Madison, WI 53706 (e-mail: <LDuBenske{at}chess.wisc.edu>)
  • Received 13 June 2007
  • Accepted 10 June 2008

Abstract

Objective Innovative approaches can strengthen patient-caregiver-clinician information exchange and more effectively address the physical and psychosocial challenges of advanced disease. This study reports initial findings from implementation of the Clinician Report (CR)—a patient and caregiver status report tool accessible by the oncology clinic team.

Design The CR tracks and communicates essential information from cancer patients and caregivers to the oncology team. The CR conveys patient symptoms, emotional strain, and key concerns.

Measurements Authors used a model developed to explain acceptance, implementation, and sustainability of Interactive Health Communication Systems (IHCS) to evaluate implementation of the new CR system. The study carried out qualitative analyses of interviews with clinicians regarding their experience utilizing the Clinician Report.

Results Primary CR benefits included enhancement of patients' clinic visit experiences, greater caregiver involvement, and facilitation of earlier interventions. Challenges included CR functional issues, users' desire for greater depth of information, user privacy concerns, and limited patient use. These findings are discussed using parameters of the implementation model. Limitations of this study include its small clinician sample size, which represented only a portion of existing organizational settings in which CR systems might be implemented.

Conclusion Though in its early implementation stages, the CR demonstrates the potential to positively impact care delivery in the cancer clinic setting, particularly by facilitating earlier interventions and improving patient-caregiver-clinician communication both during and between clinic visits.

Footnotes

  • This research was made possible through grant funding from the National Cancer Institute (1 P50 CA095817-01A1) and National Institute of Nursing Research (RO1 NR008260-01). This research was presented at the Critical Issues in eHealth Research Conference, Bethesda, MD, September 11, 2006, as a poster titled “Evaluation of the Utility of an Online Reporting System that Connects Cancer Patients and Their Informal Caregivers to Their Clinical Team.”

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