InSight Care Pilot Program: Redefining Seeing a Patient
Bobby Daly, Gilad J. Kuperman, Alice Zervoudakis, Abigail Baldwin Medsker, Ankita Roy, Alice S. Ro, Javiera Muñoz Arenas, Hrudaya Veena Yanamandala, Raj Kottamasu, Rori Salvaggio, Jessie C. Holland, Stephanie Hirsch, Chasity Burrows Walters, Tara Lauria, Hei‐Man Chow, Aaron Begue, Margarita Rozenshteyn, Melissa Zablocki, Amandeep K. Dhami, Nicholas Silva, Emily Brown, Lauren L. Katzen, Yeneat O. Chiu, Claire Perry, Stefania Sokolowski, Isaac Wagner, Stephen R. Veach, Rachel N. Grisham, Chau T. Dang, Diane Reidy‐Lagunes, Brett A. Simon, Wendy Perchick
Abstract
PURPOSE: Early detection and management of symptoms in patients with cancer improves outcomes. However, the optimal approach to symptom monitoring and management is unknown. InSight Care is a mobile health intervention that captures symptom data and facilitates patient-provider communication to mitigate symptom escalation. PATIENTS AND METHODS: Patients initiating antineoplastic treatment at a Memorial Sloan Kettering regional location were eligible. Technology supporting the program included the following: a predictive model that identified patient risk for a potentially preventable acute care visit; a secure patient portal enabling communication, televisits, and daily delivery of patient symptom assessments; alerts for concerning symptoms; and a symptom-trending application. The main outcomes of the pilot were feasibility and acceptability evaluated through enrollment and response rates and symptom alerts, and perceived value evaluated on the basis of qualitative patient and provider interviews. RESULTS: goal of 25%). Over 6 months of follow-up, the daily symptom assessment response rate was 56% (the goal was 50%), and 93% of patients generated a severe symptom alert. Patients and providers perceived value in the program, and archetypes were developed for program improvement. Enrolled patients were less likely to use acute care than were other high-risk patients. CONCLUSION: InSight Care was feasible and holds the potential to improve patient care and decrease facility-based care. Future work should focus on optimizing the cadence of patient assessments, the workforce supporting remote symptom management, and the return of symptom data to patients and clinical teams.