Electronic Post-Treatment Surveillance Program for Prostate Cancer Survivors (eHealth)

Study Overview
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Brief Summary
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The purpose of this single institution pilot study is to determine the feasibility of implementing an eHealth prostate cancer surveillance program through the eVisit electronic medical record patient portal. The investigators will assess patient compliance and satisfaction with eVisit follow up care in lieu of in person clinic visits.

Detailed Description
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Telehealth offers the opportunity to transform cancer surveillance into a patient-centered effort with shared leadership between patient and oncologist. Peer-to-peer electronic communications can improve the collaboration between oncologist and primary care provider (PCP) as patients transition back to primary care as their primary health provider. The investigators propose to test a patient-centered eHealth surveillance program utilizing novel asynchronous telehealth tools to provide patient-reported outcome symptom monitoring using the electronic medical record's patient portal (eVisit).

Official Title
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Evaluation of an Electronic Post-Treatment Surveillance Program for Prostate Cancer Survivors (eHealth)

Conditions
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Prostate Cancer

Intervention / Treatment
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* Other: eVisit


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥ 18 years old with histologically confirmed prostate cancer Completed curative intent treatment to the prostate +/- pelvis Deemed to be without evidence of active disease by treating provider with at least 1 follow up visit 3 or more months after treatment completion MyChart account or willingness to open account Access to the internet Exclusion Criteria: Documented extrapelvic metastases PSA meeting definition of recurrence (>0.2 ng/ml for prostatectomy patients or nadir + 2 ng/ml for radiation patients) and rising with doubling time less than 1 year

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: eVisit<br>The study intervention will be an electronically performed surveillance program replacing face-to-face clinic follow-up visits. At 3 month intervals for 1 year, the patient will receive an email reminder generated by the patient portal to complete lab testing and eVisit questionnaire. | Other: eVisit<br>* electronic surveillance program in lieu of in-person clinic visit<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of patients who complete all scheduled eVisits at the end of follow-up | Defined as completion of labwork and at least 80% of the questions asked at each eVisit | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of enrollment to the eVisit program | Defined as the percentage of patients who are approached for eVisit and ultimately enroll | 12 months | 
| eVisit participant reported satisfaction | Reported as the summary score from validated Brief Patient Satisfaction 10-item scale instrument assessed from 1/strongly agree through 5/strongly disagree | 12 months | 
| Number of participants with cancer treatment related toxicities | Defined specifically as CTCAE Grade 2 or higher GI, GU, hormonal, and sexual toxicities | 12 months | 
| Number of eVisit participants with cancer recurrence | Defined as biochemical progression (PSA >0.2 ng/ml for prostatectomy patients or nadir + 2 ng/ml for radiation patients) or metastasis (by imaging) | 12 months | 
| Financial impact of the eVisit program on participants compared to in person follow up clinic visits | Defined by the financial burden assessment completed by participants, scored from 0/not at all through 4/very much | 12 months | 
| Financial impact of the eVisit program on Duke University Hospital (institution) compared to in person follow up | Defined by percentage of participants/eVisits covered by insurance | 12 months | 
| Financial impact of the eVisit program on Duke University Hospital (institution) compared to in person follow up | Defined by qualitative analysis of time commitment for providers | 12 months | 
| Financial impact of the eVisit program on Duke University Hospital (institution) compared to in person follow up | Defined by qualitative analysis of reimbursement process | 12 months |