Bridging clinical informatics and implementation science to improve cancer symptom management in ambulatory oncology practices: experiences from the IMPACT consortium
Authors: McCleary Nadine Jackson , Merle James L , Richardson Joshua E , Bass Michael , Garcia Sofia F , Cheville Andrea L , Mitchell Sandra A , Jensen Roxanne , Minteer Sarah , Austin Jessica D , Tesch Nathan , DiMartino Lisa , Hassett Michael J , Osarogiagbon Raymond U , Wong Sandra , Schrag Deborah , Cella David , Smith Ashley Wilder , Smith Justin D ,   IMPACT Consortium, Cella David , Cheville Andrea , Hassett Michael J , Osarogiagbon Raymond U , Schrag Deborah , Wong Sandra L , Kroner Barbara L , Smith Ashley Wilder , DiMartino Lisa , Garcia Sofia , Griffin Joan , Jensen Roxanne , Mitchell Sandra , Ruddy Kathryn , Smith Justin D , Yanez Betina , Bian Jessica J , Dizon Don S , Hazard-Jenkins Hannah W , Ardini Mary-Anne , Ahrens Paige , Austin Jessica , Barrett Fiona , Bass Michael , Begnoche Megan , Cahue September , Caron Kimberly , Chlan Linda , Coughlin Ava , Cronin Christine , Dias Samira , Faris Nicolas , Flores Anne Marie , Garcia Martha , Hemming Karla , Herrin Jeph , Hodgdon Christine , Kircher Sheetal , Kroenke Kurt , Lam Veronica , Lancki Nicola , Mai Quan H , Mallow Jennifer , McCleary Nadine J , Norton Wynne , O'Connor Mary , Pachman Deirdre , Pearson Loretta , Penedo Frank , Podratz Jewel , Popovic Jennifer , Preiss Liliana , Rahman Parvez , Redmond Sarah , Reich James , Richardson Joshua , Richardson Kimberly , Ridgeway Jennifer , Rutten Lila , Schaepe Karen , Scholtens Denise , Poirier-Shelton Tiana , Silberman Philip , Simpson Jaclyn , Tasker Laura , Tesch Nathan , Tofthagen Cindy , Tramontano Angela , Tyndall Benjamin D , Uno Hajime , Wehbe Firas , Weiner Bryan 
Published: September 2024

Objectives

To report lessons from integrating the methods and perspectives of clinical informatics (CI) and implementation science (IS) in the context of Improving the Management of symPtoms during and following Cancer Treatment (IMPACT) Consortium pragmatic trials.

Materials and Methods

IMPACT informaticists, trialists, and implementation scientists met to identify challenges and solutions by examining robust case examples from 3 Research Centers that are deploying systematic symptom assessment and management interventions via electronic health records (EHRs). Investigators discussed data collection and CI challenges, implementation strategies, and lessons learned.

Results

CI implementation strategies and EHRs systems were utilized to collect and act upon symptoms and impairments in functioning via electronic patient-reported outcomes (ePRO) captured in ambulatory oncology settings. Limited EHR functionality and data collection capabilities constrained the ability to address IS questions. Collecting ePRO data required significant planning and organizational champions adept at navigating ambiguity.

Discussion

Bringing together CI and IS perspectives offers critical opportunities for monitoring and managing cancer symptoms via ePROs. Discussions between CI and IS researchers identified and addressed gaps between applied informatics implementation and theory-based IS trial and evaluation methods. The use of common terminology may foster shared mental models between CI and IS communities to enhance EHR design to more effectively facilitate ePRO implementation and clinical responses.

Conclusion

Implementation of ePROs in ambulatory oncology clinics benefits from common understanding of the concepts, lexicon, and incentives between CI implementers and IS researchers to facilitate and measure the results of implementation efforts.