Dr. Tami Mark is the Principal Investigator on the project entitled Assessment of a Hand-Held and Internet Information Technology System to Improve Management of Cancer Related Pain, Fatigue, and Depression that is housed at The MedStat Group in Washington, DC.

What is unique and/or innovative about your study?
We are studying a unique technology, the Supportive Oncology Services (SOS) information system that addresses the barriers to screening patients for cancer related symptoms and educates patients about their management. We are studying the technology in community oncology clinics typical of the type where it is being deployed.

The SOS e-tablet patient education system utilizes wireless, notebook-sized, pen-based computers (e-tablets) that clients use while they are waiting for their appointments or while receiving treatment. The e-tablets deploy an Intranet or Internet-based system called the Cancer Support Network which provides patients with targeted quality educational information in text, graphic, video and audio formats. Patients can view videos, read text or listen to audio on a wide range of topics such as pain management, the signs and symptoms of anemia, symptoms and treatment of psychological distress and other information relevant to oncology care.

The technology also provides potential solutions to the practical constraints of collecting relevant medical information from patients in real-time at the point of care. The SOS system employs a tested, easy-to-use software interface on the e-tablet called the Cancer Care Monitor (CCM) - a validated screening instrument that quickly collects information from individuals about their cancer-related symptoms. Users enter information by pointing and clicking on the screen of the e-tablet using a stylus provided with the device. Validated instruments gauge pain levels, fatigue and mental health status. The e-tablet results are scored and a report is sent to the appropriate physician location for attachment to the patient’s chart before the encounter commences. The CCM is administered at each visit and the results are stored in the patient chart.

How is your project progressing so far?
We have developed our protocols and instruments, installed the technology, recruited and trained site coordinators and are in the field at two community oncology clinics. Some of the challenges that we face are conducting research in a community oncology setting where research infrastructures have not been established. In addition, we are trying to encourage the clinics to adopt the technology at the same time we are preventing full adoption due to the randomization aspect of the study.

What prompted you to explore this research?
In October 2000, the National Institutes of Health released a consensus statement called “Symptom Management in Cancer: Pain, Depression, and Fatigue.” This document asserted that symptom management has not kept pace with the advances in cancer treatment and that symptoms are frequently under-identified and under-treated. Lack of patient education and provider assessment were cited as two major reasons for the lack of treatment. The SOS information system is a unique technology designed to address this important public health problem.

How would a typical end-user utilize the final product/results of your research?
An oncology clinic could review the effectiveness of the SOS information system in addressing the lack of symptom screening and treatment as well as patient education and satisfaction.

What are the greatest challenges in eHealth and more specifically, your project?
Some eHealth technologies do not lend themselves easily to evaluation using standard techniques such as randomized designs. In our project, we are concerned that while the randomization levels the playing field for comparison, it may be preventing full adoption of the technology. These issues need to be weighed when studying eHealth technologies.

In what ways would you like to see eHealth evolve?
In oncology, patients consistently indicate that they want more information rather than less and to have greater involvement in their treatment rather than be passive recipients. eHealth offers a way to more fully integrate patients into their treatment. In the case of the SOS system, patients are provided the opportunity to communicate with their providers in a structured format about their health status as well as to become further educated about their condition.

How do you stay informed of advances and innovations in eHealth?
Through information provided in professional journals, online, at conferences and through communication with providers in the field. In addition, my research organization is part of a larger company – Medstat – that provides innovative eHealth solutions.

Great update, Tami – thank you!

In October, we will hear from Dr. Kathryn Dansky of Penn State.