Enhancing cancer care through e-tools

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Patients of the Cancer Centre of Southeastern Ontario at Kingston General Hospital have welcomed a new addition to the waiting room areas – a computer-like terminal with touch screen technology that allows them to assess a variety of indicators about how they feel the day of their visit.

Since March, patients have been using the tool to track everything from their appetite to how they are feeling emotionally. The results are printed out and presented to their care team. “This is an easy way of getting a snapshot of some common issues that our patients might have,” explains Dr. Deborah Dudgeon, a palliative care physician and project lead. The patient’s visit is compared against their past self-assessments, with an electronic response being sent to a professional caregiver if there are significant variations. For example, if someone suddenly reports a loss of appetite and weight loss, a dietitian will be notified so they may consult with the patient immediately.

“We’re trying to identify symptoms at any stage of an individual’s life so they can be managed easily and effectively, to improve the person’s quality of life,” Dr. Dudgeon says. About 80 per cent of consults carried out by the palliative care team involve patients with cancer-related issues. Palliative care is more than end-of-life care; it involves the improvement of symptom management for patients at any stage of their lives.

The electronic surveillance tool is one component of a three-part project designed to improve access to palliative care through the development of an integrated delivery and communication system. The $220,000 project results from the Cancer Care Ontario’s “Access to Cancer Services Innovation Fund”.

“The electronic capture of data is new and can be somewhat intimidating for patients if they are not familiar with operating computers,” Dr. Dudgeon admits. But even after the first time, patients indicate they prefer the touch-screen method to traditional paperwork.

Patient care is improved because the health care team has the ability to track a patient’s symptoms over time and observe how interventions such as radiation treatments have improved pain intensity.

The second phase of the project involves palliative care patients completing a similar symptom management process on-line at home. To be completed daily, Dr. Dudgeon reports that alerts will be sent to the Community Care Access Centre or to their physician if their symptoms are out of control. For patients without access to the Internet, the group is currently working on a telephone-based system.

Phase three builds on 10 years of work towards an electronic patient record by Drs. Ivan Stewart and Greg Patey along with the Queen’s University Anesthesiology Informatics Laboratory. Care providers will have wireless access to a patient’s most current health data through the use of a laptop or tablet. In areas where wireless technology is not available, care providers will be able to plug computers into a phone line to access the data.

“Our hope is that if a person is seen in the community, that all their care notes will be there. That includes trips to emergency, etc.,” Dr. Dudgeon says. While improving access to care, the project also means patients no longer have to repeat their care histories to each care provider.

Each of the pilot projects will be completed and evaluated by September to determine their effectiveness. Dr. Dudgeon is the Cancer Care Ontario provincial lead for palliative care.

Affiliated with Queen’s University, Kingston General Hospital is a 456-bed teaching hospital that serves more than 500,000 people in southeastern Ontario and is the community hospital for the Kingston area. KGH provides an array of specialized acute and ambulatory clinical services including trauma, cardiac, stroke, pediatric, perinatal, end stage renal and stem cell transplants. Home to the Cancer Centre of Southeastern Ontario, KGH is dedicated to compassionate, high quality health care in a dynamic academic research environment. It features a robust research program and provides hands-on skill training for 1,200 health care students annually. For more information, visit the web site at www.kgh.kari.net