Automated EHR System Enhances Cancer Care Efficiency and Outcomes

A recent study led by researchers at the Mayo Clinic has demonstrated that an automated electronic health record (EHR) system can significantly enhance cancer care by improving efficiency and patient outcomes. The study focused on managing symptoms such as pain, anxiety, and insomnia, which often lead cancer patients to seek emergency care. This innovative approach, known as the Enhanced EHR-Facilitated Cancer Symptom Control Trial (E2C2), has shown promising results in reducing hospital visits and alleviating distress among patients.

Dr. Andrea Cheville, a professor of Physical Medicine and Rehabilitation at the Mayo Clinic Comprehensive Cancer Center, emphasized the ambitious goal of the study. She stated, “We wanted to see if automating symptom check-ins and care through the electronic health record could improve patients’ lives without adding to the burden on oncology teams.” The findings revealed that the system not only helped manage symptoms such as anxiety and depression but also kept thousands of patients from requiring hospitalization.

For participants like Becky Johnson, the trial provided valuable support during a challenging time. Diagnosed with double breast cancer at age 40 in 2022, Johnson struggled with sleep due to anxiety and medication side effects. “I was continually Googling for more information about treatments, prognosis, new terminology, and the experiences of others,” she explained. The trial required her to submit digital surveys regarding her health, allowing healthcare professionals to address her insomnia effectively. A nurse reached out with tailored advice, leading to significant improvements in Johnson’s sleep quality.

This innovative method became possible through automations in the Plummer Chart, the EHR software managing patient records at Mayo Clinic. Between 2019 and 2023, over 50,200 patients from 15 cancer specialties participated in the E2C2 trial. Participants completed brief surveys about various symptoms before clinic visits and monthly in between. The EHR system sorted responses automatically, with mild scores logged, moderate scores generating self-care tips, and severe scores prompting outreach by a remote symptom care manager, such as a nurse or social worker.

The trial’s results highlighted the effectiveness of the automated system. Patients reported experiencing 40% to 60% fewer acute care encounters, including hospitalizations and emergency department visits. Notably, this was achieved with only a small team of 2-3 full-time care managers supported by 20% of one physician’s time.

The E2C2 trial represents a significant advancement in how digital tools can be utilized in oncology care. By automating routine monitoring and triaging patient symptoms through the EHR, healthcare teams can effectively support a large number of patients. Dr. Cheville remarked, “The gains we saw are encouraging and point to a scalable way to extend supportive oncology care beyond the clinic walls, meeting patients where they are.”

Funding for the E2C2 trial was provided by the National Institutes of Health and the National Cancer Institute (NCI) as part of the Cancer Moonshot initiative. The study’s findings were published in The Lancet Oncology, underscoring the potential of digital health interventions in improving cancer care.

As healthcare continues to evolve, the successful implementation of automated systems like EHRs may become a standard practice, enhancing patient care and streamlining operations within oncology departments. The next phase of this research aims to ensure that these tools are made accessible to healthcare teams, enabling them to effectively reach every patient in need of supportive care.