{"entity":{"id":"idea-acc-electronic-pro-monitoring-standard","kind":"idea","name":"Weekly electronic symptom reporting as a standard of care during systemic therapy","aka":[],"tldr":"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.","asOf":"2026-09-08","links":[{"label":"Basch et al., JAMA 2017: overall survival with PRO monitoring","url":"https://jamanetwork.com/journals/jama/fullarticle/2630810"}],"tags":[],"related":[],"cancers":[],"sections":["supportive-care"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-care-fragmentation","b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","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","cost":"medium","horizonYears":2},"route":"/ideas/idea-acc-electronic-pro-monitoring-standard/","neighbours":{"section":[{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"bottleneck":[{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-basch-epro-survival-jama-2017","kind":"paper","name":"Basch: asking patients to report symptoms online during chemotherapy improved survival","route":"/key-papers/paper-basch-epro-survival-jama-2017/"}]}}