Implementing Electronic Symptom Screening for Telehealth Visits (2020-2021)

Symptom monitoring is integral to quality oncology care. Research shows that the collection and monitoring of patients’ symptoms using electronic Patient Reported Outcomes (ePROs) assessments can enhance care and lead to improved quality of life, prolonged survival and reduced resource utilization. The Duke Cancer Institute has successfully implemented ePRO assessments into routine in-person cancer care visits; however, there is currently no method for collecting and utilizing ePRO symptom screening data in the context of telehealth visit workflows, which have rapidly increased due to COVID-19.

This project team developed a system that implements ePROs for telehealth visits. Team members designed a flowchart outlining the steps that needed to be taken to implement the Edmonton Symptom Assessment Survey-Revised (ESASr), into telehealth visits. The team worked to minimize the survey fatigue patients experience and optimize the platform for physicians by incorporating it into the existing workflow framework. Team members identified physicians to participate in the test run and worked with Duke Health IT to refit the ESASr survey used in a previous project and implement it into the e-check in process.

The trial-run workflow became active in Spring 2021 and in the process of being evaluated through interviews with participating physicians. The current pilot of seven from across Duke Cancer Institute may be expanded to include more departments and individuals. The ultimate goals is to apply lessons learned to expand the use of ESASr in telehealth and in-person visits.


Fall 2020 – Spring 2021

Team Outputs

Integrating Self-monitored Symptom Data into Telehealth Visits (2021 Fortin Foundation Bass Connections Virtual Showcase)

Implementing Electronic Symptom Screening for Telehealth Visits (poster by Kris Herring, Thomas Leblanc, Timothy Tsai, Michael Tang, Laura Benzing, Augusto de Leon, Alexander Hong, Alexandra Lawrence, Joshua Nidus and Reanna Shah)

This Team in the News

Senior Spotlight: Reflections from the Class of 2023


Image: With expanded options for telehealth, Duke doctors and patients can connect for virtual visits, by Duke Health/Duke Today


Team Leaders

  • Kris Herring, Duke Cancer Institute
  • Thomas Leblanc, School of Medicine-Medicine: Hematology

/graduate Team Members

  • Michael Tang, Interdisciplinary Data Science - Masters
  • Timothy Tsai, Mgt of Clinical Informations

/undergraduate Team Members

  • Laura Benzing, Biology (BS)
  • Alexander Hong, Interdepartmental Major
  • Alexandra Lawrence, Statistical Science (BS)
  • Joshua Nidus, Biology (BS)
  • Reanna Shah, Biology (BS)
  • Augusto de Leon III, Biology (BS)

/yfaculty/staff Team Members

  • Steven Wolf, School of Medicine-Biostatistics and Bioinformatics