OBJECTIVES: An essential potential of using electronic Patient Reported Outcomes in clinical practice is symptom detection. The aim is to present the efficiency related with detecting symptoms among radiotherapy patients and changing their follow-up protocol increasing telemedicine in a Spanish tertiary hospital.

METHODS: The PROMs considered for treatment follow-up among endometrial and cervix cancer patients were discussed in 2023 in consecutive meetings between the hospital PROM-team and a multidisciplinary care team (nursery, onco-radiotherapists). The final symptom-outcomes consensus were a mix between PRO-CTCAE and EORTC items. FACT questionnaire was also included to assess quality-of-life evolution. Former follow-up protocol included one face-to-face visit per radiotherapy cycle. New protocol was two face-to-face visits (first/last cycle), one telematics visit (third week), and additional telematic visits if PROM-frequency and intensity related-alerts were activated. Direct public direct care costs were estimated considering the last published Catalan Healthcare Institute tariffs. Patient Reported experience was also collected through centralized own-hospital SMS questionnaires on telemedicine.

RESULTS: 16 patients were invited (October 2023-June 2024). 4 rejected to participate or to complete the RT full 5-weeks follow-up. 7 final paticipants received cervix and 5 endometrial radiotherapy. By June-2024 all patients but three answered to at least 4 of the 5 weekly cycles of questionnaires. An average of 44% of contacts/cycle were related with alerts. Subsequently, a 41% of direct cost savings were estimated applying the protocol change (195€ per patient follow-up costs). Patients did not make relevant complaints through the experience questionnaires.

CONCLUSIONS: Telemedicine and the availability of centralized hospital apps enabling PROMs registry are related with new scale-up opportunities to improve processes care and avoid none-value resource use. The succeful protocol change is serving as an inspiration to expand the experience in other indications and chemotherapy.