Electronic symptom checklists can be used to help improve patient-clinician communication.
In 2015, approximately 1.65 million new adult cancer cases are expected to be diagnosed, and an estimated 10,380 new cases are expected in children 14 years old and younger, according to the American Cancer Society. Studies have shown that the adverse effects of treatment experienced by oncology and hematology patients are under-reported in medical records.
The Therapy-Related Symptom Checklist for Adults (TRSC) and the TRSC for Children (TRSC-C) are used to encourage cancer patients to report treatment-related symptoms to their physician. A group of researchers, including Department of Health Administration and Policy Affiliate Faculty Arthur R. Williams and HAP Professor Farrokh Alemi, are taking that one step further and pilot testing the idea of using computers for emotional support and for gathering a patient’s symptom information.
To do that, they are examining e-health applications of the TRSC and TRSC-C. Their study, published in BioMedical Engineering Online, discusses the system design and efforts to create an electronic system for the TRSC and TRSC-C that is able to demonstrate empathy, while obtaining a complete list of symptoms from the patient.
“These checklists can be used to help guide patient-clinician conversations so the discussion is more focused and can specifically address treatment concerns and symptom management,” Williams said. “Using an electronic system enables patients to have more frequent contact and communication with their clinician.”
The pilot test is evaluating an electronic system that combines telephone-voice communications with computer algorithms to allow patients to report symptoms and respond to the TRSC or TRSC-C using a common language. The electronic system’s design is focused on the computer’s recognition of symptoms, the ability to modify interactions with patients based on the patient’s responses over time, and how the computer can use active listening skills to address the patient’s concern. These empathetic computer systems are able to demonstrate an understanding of the patient’s responses and essentially create a conversation between the computer and the patient.
“Computers are machines, no doubt about it; however, patients expect and deserve machines that show understanding of interactions,” Alemi said. “If computer interviews are empathetic, patients may be more likely to continue with these interviews.”
The computer shows empathy, in part, by recognizing open-ended responses, paraphrasing the patient’s responses, asking leading questions for anticipated responses, linking the response to the patient’s history, and providing the patient with a summary of what is being communicated to their physician.
“The system uses human voice capability to respond to patient inquiries or to make telephone calls to patients,” Williams said. “We see this electronic system as a way to take the TRSC and TRSC-C checklists one step further to improve patient communication with clinicians either before or after a face-to-face interaction.”