# Weekly electronic symptom reporting as a standard of care during systemic therapy

Source: https://onco.cc/ideas/idea-acc-electronic-pro-monitoring-standard/  
OnCo record `idea-acc-electronic-pro-monitoring-standard` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Patients on chemotherapy who report their symptoms weekly through an app, with nurses acting on alerts, live longer and visit emergency rooms less. This should be routine and paid for.

## Summary

Randomised trials (Basch and colleagues, 2016-2022) showed that routine electronic patient-reported outcome monitoring with nurse response improves quality of life, reduces emergency visits, and in one trial improved overall survival. Adoption remains patchy because of workflow and payment barriers. The proposal is to make PRO monitoring a reimbursed standard of care during systemic therapy, with minimum response standards and open symptom item sets.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Systems that adopt reimbursed PRO monitoring will reduce emergency attendance during chemotherapy by at least 10% and improve symptom control scores, replicating trial effects at population scale.
- Rationale: The effect is one of the largest supportive-care benefits with Level 1 evidence; the barrier is implementation, which payment and standards can address.
- Proposed test: A payer-led rollout across multiple practices with matched-control comparison of emergency visits, hospitalisations, and patient-reported symptom burden.
- Maturity: being-tested-at-scale
- Actor: payer

## Sources

- Basch et al., JAMA 2017: overall survival with PRO monitoring: https://jamanetwork.com/journals/jama/fullarticle/2630810

## Connected records

- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- key papers: [Basch: asking patients to report symptoms online during chemotherapy improved survival](https://onco.cc/key-papers/paper-basch-epro-survival-jama-2017/)

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