Genitourinary Cancer

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SU_24_2240 - Virtual PSA Monitoring Program Pilot: The integration of technology in post treatment prostate cancer patient care to optimize workflow and increase access to care.

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Virtual PSA Monitoring Program Pilot: The integration of technology in post treatment prostate cancer patient care to optimize workflow and increase access to care.
R. Boyajian1, A. Simeoli2, P. F. Orio III3, N. E. Martin4, M. King5, K. Mouw6, A. V. D'Amico7, and P. L. Nguyen8; 1Dana Farber/Brigham and Women's Cancer Center, Boston, MA, 2Brigham and Women's Department of Radiation Oncology, Boston, MA, 3Brigham and Women's Hospital, Boston, MA, 4Department of R, Boston, MA, 5Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA, 6Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA, 7Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, 8Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA

Purpose/Objective(s): The Virtual PSA monitoring program (VPSAM) was designed to reduce in person follow up & improve access to care. Software was created around an evidence based rules engine to optimize workflow utilizing decision support & automated scheduling capabilities.

Materials/Methods: PRE- PILOT- A Multidisciplinary team developed evidence based guidelines to create the rules engine. Patients from a single radiation oncologist’s practice who completed radiotherapy were offered to continue with in person follow up or participation in the program. Recruitment letters were mailed & others were approached during in clinic follow up. Enrollees had their demographic, staging & treatment data entered in the software. This data automatically generates monitoring schedules & calculated individualized PSA relapse level. The software sent automated email reminders that their PSA level were due & instructed them to go to a predesignated lab. The E-mail also contains a link to an AUA/EPIC-26 questionnaire. The PSA results were placed in the software, once they were received. The AUA/EPIC-26 automatically uploads when completed. The NP contacted patient about results, then completed the software visit form, sets the automated schedule & sends appropriate lab orders. Completion of this form triggers a post visit survey to be sent & is uploaded when completed.

Results: Between March & September 2016, 278 patients were approached. 251 (90.2%) enrolled & 27 (9.8%) declined. Compared to historical data, the pilot demonstrated a 34% reduction with in-person follow ups (37.6 vs 25.0) with a 27% increase in consultations per month (28.7 vs 36.5). Optimizing workflow allowed our practice to care for 26% more patients per month (82.7 vs 104.2). This translated into a 20% increase in our prostate cancer treatment volume. Our department saw more than $825,000.00 in new revenue because of the program. During the pilot, 119 patients were sent post visit surveys, 51 were returned (42.8%). Responders indicated 98% understood their PSA results. 96% understood their plan of care & VPSAM was more convenient. 90% indicated VPSAM reduced travel related stress & expenses with 66% saving > 3 hours of travel time. During the pilot, 191 virtual visits were conducted (27.3/month). After the pilot concluded, the program was open to all the department’s radiation oncologists. In the fall of 2017, it was expanded to the department’s four satellite facilities. In 2017, 483 virtual visits were done (40.25/month). As of January 2018, the program has 582 active patients & 827 virtual visits have been conducted.

Conclusion: Virtual PSA Monitoring utilizing VPSAM software has successfully altered the workflow of post treatment prostate cancer care, reducing patient inconvenience while preserving patient satisfaction and improving access to care by facilitating new slots for new patients to be seen. The VPSAM was strongly positive in terms of patient experience, patient access, and net financial impact.

Author Disclosure: R. Boyajian: Assistant director of Cancer Survivorship Program; Dana Farber Brigham and Women's Cancer Center. A. Simeoli: None. P.F. Orio: Honoraria; CR BARD. Advisory Board; Augmenix. President-Elect &Chairman, Socioeconomic Committee; American Brachytherapy Society. President-Elect; American Brachytherapy Society. RUC alternate advisor; ASTRO. N.E. Martin: Consultant; Via Oncology. M. King: None. K. Mouw: Advisory Board; Pfizer, EMD Serono. A.V. D'Amico: None. P.L. Nguyen: Honoraria; Bayer. Consultant; Astellas, GI Windows, Infinity Pharmaceuticals, Nanobiotix, Augmenix. Advisory Board; Dendreon, Genome DX, Medivation, Ferring. Stock Options; Augmenix. Program Committee; Genitourinary Cancers Symposium.

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