Implementation of an ePRO-based system supporting treatment readiness assessments in lung cancer care: a mixed-methods study.

PURPOSE: Electronic patient-reported outcomes (ePROs) have shown clinical benefits in oncology. Although widely used for symptom monitoring during and after cancer treatment, their potential to replace existing workflows, such as treatment readiness assessment without a direct clinical encounter, remains underexplored. Real-world evidence on the feasibility, acceptability, and resource implications of such approaches is limited. This study evaluated the implementation and use of an ePRO-based system to support treatment readiness assessments in lung cancer care. METHODS: A mixed-methods study guided by the RE-AIM framework was conducted in routine lung cancer care at a Danish oncology department. Quantitative data from the ePRO platform and electronic health records were used to assess uptake and questionnaire completion. Qualitative data from field observations and semi-structured patient interviews were used to examine workflow integration, user experiences, and perceived value. Changes in staff time use before and after implementation were estimated by combining registry data, field observations, and staff input. RESULTS: A total of 704 patients completed at least one ePRO questionnaire between December 2020 and March 2024, corresponding to 6,134 completed questionnaires. Treatment-level completion increased from 17.7% to 76.3%. In practice, ePRO data were used alongside blood test results, prior medical history, and clinical judgement to assess treatment readiness. The ePRO-based workflow was estimated to reduce nurses' time use by approximately 6 min per treatment. Patients and staff generally found the system meaningful and acceptable. CONCLUSION: The ePRO-based system appeared feasible to integrate into routine lung cancer care and supported more targeted treatment readiness assessments.