{"entity":{"id":"idea-moon-pro-monitoring-standard","kind":"idea","name":"Weekly symptom check-ins with automatic alerts as standard of care on treatment","aka":[],"tldr":"Patients on chemotherapy or immunotherapy answer a short weekly symptom questionnaire on their phone; severe answers alert the nurse the same day. Trials show this prolongs life.","summary":"Electronic patient-reported outcome monitoring with nurse alerts improved quality of life, reduced emergency visits and improved overall survival in a randomised trial at Memorial Sloan Kettering (Basch et al.) and in the PRO-TECT cluster-randomised trial in community practices. Uptake remains low because nobody is paid for the nursing time. The proposal is a reimbursed care standard: every patient on active systemic therapy is offered weekly ePRO monitoring with defined alert thresholds and response times, and payers cover the monitoring as they cover a drug.","asOf":"2026-09-08","links":[{"label":"NCI PRO-CTCAE","url":"https://healthcaredelivery.cancer.gov/pro-ctcae/"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["mskcc"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-patient-voice","b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"System-wide ePRO monitoring reduces unplanned admissions during systemic therapy by at least 15% and improves symptom control, and the savings exceed the cost of nursing time.","rationale":"Clinicians under-detect symptoms between visits; early management of dehydration, pain and nausea prevents cascades to admission. The evidence base is unusual in supportive care for including a survival signal.","test":"Payer-led pragmatic rollout with a randomised stepped start across practices; measure admissions, emergency visits, dose intensity delivered and patient-reported symptom burden.","maturity":"being-tested-at-scale","actor":"payer","cost":"medium","horizonYears":3},"route":"/ideas/idea-moon-pro-monitoring-standard/","neighbours":{"institution":[{"id":"mskcc","kind":"institution","name":"Memorial Sloan Kettering Cancer Center","route":"/institutions/mskcc/"}],"bottleneck":[{"id":"b-patient-voice","kind":"bottleneck","name":"Patients lack understanding, navigation and agency","route":"/bottlenecks/b-patient-voice/"},{"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/"}]}}