Skip to main content

Table 5 Staff quotes regarding the PRMs system

From: Stepping into the real world: a mixed-methods evaluation of the implementation of electronic patient reported outcomes in routine lung cancer care

A

“I have just seen another patient today with a phone interpreter who has scored red in several categories which I did not pick up on during the consultation. There is so much to go through in a medical consultation that clearly, we miss out on evaluating the psychosocial and practical concerns of the patient, unless they bring it up themselves. Clearly, I have not been doing this well for previous patients. Hooray for PROMs” (L046, radiation oncologist)

“I think it [the PROMs system] addresses a very important gap that we have discussed previously, and I think it helps both the doctors and the patients at trying to narrow that gap. ….. at least they [patients] feel like they have been heard.” (B011, medical oncologist)

“There’s been more appropriate referrals. So, yeah… I think sometimes like I said social work could be a very grey area… whereas this [the care coordinator referral] has very specific reasons for why social work would need to be involved.” (L054, social worker)

“…we do have more contact with patients.” (L007, care coordinator)

B

Personally, it is what we have been doing anyway, so it’s formalizing it. From my point of view, it’s more registering the importance of that and making the patient realize that they can concentrate by doing the PROMs on questions that incidentally might happen when the patient is with the consultant, so they feel more relaxed and that everybody is working together with them and that they are the centre of care which is how everything should be.” (L003, care coordinator)

C

“I think it’s really difficult [using ePROs with non-English speaking population and referring them to allied health service] because each cultural group has different intricacies about what they find acceptable or not with medical care and how open they are to receive care…” (L056, radiation oncologist)

“CALD [culturally and linguistically diverse] care coordinators would be a great idea… It’s difficult dealing with interpreters.” (L046, radiation oncologist)

“The care coordinator CALD model will be very important to understand language and culture.” (L058, information technology staff)

D

“… the best thing is not to onboard in clinic; it’s better to do it over the phone.” (L007, care coordinator)

“It’s better if the patient can complete the survey from home…. the iPad is not practical.” (B008, care coordinator)

“Patients on maintenance or survivorship—we need to add another booking [queued appointment to complete the survey] and then you could stretch it out probably every 3 months.” (L003, care coordinator)

“What I find though is that patients’ feedback (not all of them) but some find the constant needing to do a survey… a bit too … intense for them. It depends on how well they [patients] are… those ones with a lot of problems, they [patients] sometimes just reported it and obviously you don’t address every single one [issue] at the same time but more in terms of priorities. And then not long after they are asked the same thing again, and you haven’t even sorted out all the others…” (C009, medical oncologist)

E

“I think I probably didn’t use it as much as I should have, but I have used the tab. It wasn’t any extra burden. I thought it was good having [care coordinator name] there, she would just email me and flag if there was something that hadn’t been addressed for the patient… she would email me and say ‘hey, this came up from the PROMs. Could you please talk about it and address it?’… I think most issues were resolved with that [referring to the communication with care coordinator].” (L056, radiation oncologist)

“I read the notes [from the care coordinator] before the appointment… It [the CINSW PRMs system] does fill the gap.” (B011, medical oncologist)

F

“[Care coordinator name] has been great. She names the reason of the referral in the referral form. The care coordinator has been critical. It is an entrance point [the work of the care coordinator]… then I am able to address that. It is a point of engagement… I always have ongoing conversations with the care coordinator to discuss patients.” (L054, social worker)

G

Doctors are still unaware of the whole concept. So, lack of support from them. Not acknowledging PRMs at the time of consult and discuss the concerns from that while seeing the patient leading to mistrust of the patients and carers continuing the future surveys.” (B008, care coordinator)

“We need the clinicians to understand they need to check the PROMS… clinicians need to acknowledge it, open the report when sitting with the patient.” (L003, care coordinator)

H

“It is applicable if we have sufficient care coordinators for all tumour sites. …It comes back down to the resources because [it] is very labour and resource intensive. It’s all good that you get them [the PROMs] to identify what’s their problems, but then what are you going to do about them? And I guess it’s also trying to address those issues requires more people. Sometimes, you need a psychologist, but then the psychologist can only just handle so much, and we only got part-timers. So, if you’ve got unlimited amount of resources and money, then it would be ideal…” (C009, medical oncologist)

“We make the referrals as soon as they have done the PROMs… so we make the referral to whatever they need to go. But I guess… how long does it take for that referral to get picked up?” (L007, care coordinator)

I

“It’s been quite a holistic form of providing care for people. It’s more of a team way of approach for the patient and their care.” (L054, social work)