Dr Kathi Mooney Discusses Improving Patients' Quality of Life Through Technology

Kathi Mooney, PhD, RN, FAAN, of the University of Utah, discussed technologies that she and her team created to help improve the quality of life of patients with cancer and their families. In particular, Mooney explained the impact of the "Symptom Care at Home" platform and the "Huntsman at Home" program.

At the University of Utah, Mooney is a distinguished professor within the College of Nursing and currently holds the Louis S. Peery and Janet B. Peery presidential endowed chair in nursing. She is also a co-leader of cancer control and population sciences at the University of Utah's Huntsman Cancer Institute. Mooney recently presented at The American Journal of Managed Care^®’s Institute for Value-Based Medicine^® event on November 2, 2023, in New York City.

Transcript

What technologies have you and your team developed to improve the quality of life for cancer patients and their families?

We have been interested in how to decrease symptom burden in cancer patients for now over 20 years. We started with the idea that one of the issues is communication between patients and their providers about their symptoms, and how we found, in patients, even though we provide them self-management booklets, and they may have a chemotherapy class, that, in spite of that, they still have difficulty at home in achieving symptom management. My concern was that we aren't very good at monitoring patients at home.

So, our initial research looked at developing a patient-reported symptom platform called "Symptom Care at Home," where patients on a daily basis, when they were at home, reported their symptoms and then received automated self-management coaching just in time around the symptoms they were actually experiencing at the severity levels they were experiencing. This helped improve on how we do it. Now, rather than giving patients a bunch of information when they have no symptoms that then they're supposed to refer to when they do is to actually provide symptom information at the time their experiencing symptoms.

So, that was an automated system. Then, we had alert functions put in. So, symptoms that were at moderate or severe levels would trigger an alert to a nurse practitioner who would respond to the patient to see if adjustments in their care were needed in order to bring the symptoms down so that they didn't proceed to an acute episode.

What outcomes have you observed when implementing these interventions in real-world settings?

In terms of Symptom Care at Home, we found that it decreased severe symptom days by two-thirds, moderate symptom days by 40%, and increased mild symptom days and no symptom days. So, it really reversed the experience that patients have now with usual care in terms of the number of days that they are experiencing significant symptom burden. It also decreased the use of emergency departments and rehospitalization. So, it really was very effective in helping patients manage symptoms at home.

In terms of the Huntsman at Home program that I'm talking about, the Oncology Hospital at Home, that provides acute-level care when patients do have symptoms that require a response that would either normally be to an emergency department or hospitalization. Again, we found with that program, when we evaluated it, it about cut in half the number of emergency department visits and hospitalizations that were required to manage symptoms. It also reduced costs by nearly 50%, as well. So, it was effective in terms of supporting patients at home, not requiring unplanned health care utilization, and also decreasing costs.