High River

Researchers are examining how a remote symptom monitoring and management program affects people with cancer and healthcare system efficiency. This program allows patients to complete electronic symptom questionnaires from home between clinic visits and receive advice from a study nurse. The study also aims to understand how this electronic symptom monitoring impacts clinic workflow and resource use. The study uses a stepped-wedge effectiveness-implementation design across six cancer clinics over 1.5 years, including tertiary, regional, and community centers. The study involves two main interventions: a study nurse digitally monitoring patients' symptom complexity to provide timely symptom management between visits, and support for clinic teams to hold weekly planning sessions using electronic symptom data. Patients will complete electronic Patient Reported Outcomes (PROs) questionnaires weekly if on active treatment or monthly if on follow-up. The nurse uses a complexity algorithm to identify patients needing more support, and clinic teams use this data to tailor care, including virtual or nurse-led visits for stable patients. Participants will report symptoms and concerns from home and discuss them with a study nurse. Quality of life and self-rated health will be measured at baseline, 3 months, and 6 months. Researchers will track emergency department visits, hospital admissions, and economic outcomes over about 18 months. Feedback on patient experience will be collected, and the study will include interviews to better understand results and factors affecting implementation. This approach aims to improve personalized symptom management, patient outcomes, and clinic efficiency throughout the cancer journey.