Evaluating Clinician Perceptions to a Symptom Monitoring and Reporting System (SyMon-SAYS) for Children With Cancer

OBJECTIVES: The Symptom Monitoring & Systematic Assessment and Reporting System in Young Survivors (SyMon-SAYS) program gathers weekly patient-reported symptom scores to monitor symptoms between clinical visits, enabling timely intervention for children with cancer. Clinicians' acceptance is crucial for the success of such programs but is often overlooked. This paper addresses this gap by evaluating clinicians' perceptions of the 16-week SyMon-SAYS trial.

METHODS: Pediatric cancer patients (ages 8-17) undergoing therapy were recruited. Weekly, these patients completed a 9-symptom assessment via the Epic (an electronic health record system) patient portal. Alerts triggered by symptoms exceeding a predetermined threshold notified clinicians, who documented their responses. Symptom score reports were available in Epic for review by clinicians and patients/parents. At the end of the trial, treating clinicians (attending, residents, fellows, APNs) completed a 14-item evaluation survey. A single clinician could respond to multiple surveys if more than one of their patients participated.

RESULTS: A total of 128 surveys were sent to clinicians treating 97 participants who completed the 16-week trial. Of these, 68 surveys were completed: 31 by MD/ODs (including fellows), 20 by APNs, and 17 by respondents with unknown roles. 83% of respondents did not think SyMon-SAYS added to their workload. However, responses to other items varied widely. APNs were significantly less favorable (p<0.05) towards SyMon-SAYS compared to MD/ODs, especially regarding interest in using the system, its impact on patient care, facilitating communication, and the usefulness of automated symptom monitoring.

CONCLUSIONS: By evaluating real-world data, it was found that although the majority acknowledged that SyMon-SAYS did not add extra workload, clinicians with different clinical roles reported varying perceptions of the program. This suggests that future programs should be tailored to accommodate the diverse roles of clinicians.