ArticleJCO oncology practice2026
Staff Perspectives on Normalizing and Sustaining Electronic Patient-Reported Outcomes Monitoring at Six US Health Systems.
Article in JCO oncology practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
purposeWe assessed the perspectives of staff from six health systems to understand how electronic Symptom Management (eSyM), an eSyM program that supports patients during chemotherapy and after surgery, is normalized and sustained.
methodsStarting in 2019, we integrated eSyM into routine clinical practice and assessed its effectiveness using a cluster randomized stepped-wedge trial design. At least 1 year after implementation, we administered cross-sectional surveys to elicit the perspectives of physicians, nurses, advanced practice providers (APPs), hospital administrators, information technology, and research staff using the Normalization MeAsure Development (NoMAD) and the Clinical Sustainability Assessment Tool (CSAT).
resultsOf the 211 staff who initiated the survey, 169 (80%) completed it. Respondents included 64 nurses (38%), 38 physicians (23%), 20 research staff (12%), 17 APPs (10%), 16 administrators (10%), and nine information technologists (5%). The mean NoMAD familiarity score was 5.90 (standard deviation [SD], 3.06) and the mean score for eSyM becoming a part of routine practice was 4.84 (SD, 3.21), scored on a 0-10 scale. Compared with physicians, nurses reported higher familiarity scores and lower NoMAD domain scores for
conclusionClinical staff reported moderate levels of normalization and capacity for sustainability. Nurses and APPs reported lower levels of sustainability compared with physicians and administrators. Future studies should explore novel workflows and tools that support clinical staff who provide symptom management support.
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