PV QA 1 - Poster Viewing Q&A 1
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.
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