Integrating mHealth in Oncology: Experience in the Province of Trento.

BACKGROUND: The potential benefits of the introduction of electronic and mobile health (mHealth) information technologies, to support the safe delivery of intravenous chemotherapy or oral anticancer therapies, could be exponential in the context of a highly integrated computerized system. OBJECTIVE: Here we describe a safe therapy mobile (STM) system for the safe delivery of intravenous chemotherapy, and a home monitoring system for monitoring and managing toxicity and improving adherence in patients receiving oral anticancer therapies at home. METHODS: The STM system is fully integrated with the electronic oncological patient record. After the prescription of chemotherapy, specific barcodes are automatically associated with the patient and each drug, and a bedside barcode reader checks the patient, nurse, infusion bag, and drug sequence in order to trace the entire administration process, which is then entered in the patient's record. The usability and acceptability of the system was investigated by means of a modified questionnaire administered to nurses. The home monitoring system consists of a mobile phone or tablet diary app, which allows patients to record their state of health, the medications taken, their side effects, and a Web dashboard that allows health professionals to check the patient data and monitor toxicity and treatment adherence. A built-in rule-based alarm module notifies health care professionals of critical conditions. Initially developed for chronic patients, the system has been subsequently customized in order to monitor home treatments with capecitabine or sunitinib in cancer patients (Onco-TreC). RESULTS: The STM system never failed to match the patient/nurse/drug sequence association correctly, and proved to be accurate and reliable in tracing and recording the entire administration process. The questionnaires revealed that the users were generally satisfied and had a positive perception of the system's usefulness and ease of use, and the quality of their working lives. The pilot studies with the home monitoring system with 43 chronic patients have shown that the approach is reliable and useful for clinicians and patients, but it is also necessary to pay attention to the expectations that mHealth solutions may raise in users. The Onco-TreC version has been successfully laboratory tested, and is now ready for validation. CONCLUSIONS: The STM and Onco-TreC systems are fully integrated with our complex and composite information system, which guarantees privacy, security, interoperability, and real-time communications between patients and health professionals. They need to be validated in order to confirm their positive contribution to the safer administration of anticancer drugs.

OncoQUAL: a clinical instrument panel for quality assessment in cancer care.

We present OncoQUAL, a clinical instrument panel for quality assessment in cancer care. OncoQUAL is fully integrated in an oncological electronic patient record (OEPR) and it enables oncologists to interactively retrieve clinical data for performing process and outcome-based measures of quality of care. The capability of incorporating accurate and timely 'internal' quality measurements into the daily work of clinicians is essential for moving towards a user-oriented approach to the improvement of quality of care processes.

Experience in designing and evaluating a Teleconsultation System supporting shared care of oncological patients.

This poster present our experience in designing, developing and deploying a Web-based Teleconsultation System based on a Patient Centered Oncological Electronic Medical Record (PEMR) specifically de-signed to provide clinicians a cooperative work tool supporting the oncological patient management. An evaluation phase in a clinical setting was performed when the system was deployed in the hospitals. A second evaluation phase after two year of utilization has been carrying on.