RPD319 - Portal-enabled elicitation of patients’ health-related values in solid tumor oncology

Key Message : The electronic patient portal is an effective method for eliciting health-related values (HRV) in patients with solid tumors. Portal-elicited HRV may be scalable and implemented in multiple clinical settings and studies of real-world integration are underway.

Abstract:

Background: The electronic patient portal is increasingly used to improve the efficiency of patient-clinician communication. We previously demonstrated that nurse-led, in-person discussions of patients' health-related values (HRV) resulted in higher patient ratings of clinician communication quality (1, 2).

Objective: This study aimed to demonstrate the adaptability of HRV questions from an in-person to portal context as a tool for delivering person-centered oncologic care.

Methods: From July 2023 to August 2024, HRV questionnaires consisting of 7 questions (3) were sent by electronic patient portal to individual patients of 5 oncology clinics: 4 gastrointestinal (GI) and 1 genitourinary (GU). Thematic content analysis was performed to identify key domains, categorize codes, and identify congruence and divergence of thematic constructs.

Results: Of the 1,556 HRV questionnaires sent to individual patients, 852 patients responded to at least one question. A random subset of 200 patient responses (167 patients with GI cancer, 33 patients with GU cancer; 23% of all respondents) were analyzed by an interdisciplinary team. Analysis identified five themes, consistent with prior findings from in-person discussions: cancer as threat/disruption; expression of personhood and desire to retain a sense of self; communication with loved ones and the medical team as a tool for maintaining individual agency; connection to others as core to social identity and a source of individual strength; and sources of meaning and fulfillment. Uniquely identified by our analysis of portal responses were elements of financial toxicity and spiritual and existential well-being.

Conclusions: Elicitation of patient values through the electronic portal provided valuable insights into HRV of patients with solid tumor diagnoses. Compared with in-person discussions, the portal provides an efficient, scalable approach for capturing HRV while preserving thematic depth. Ongoing research investigates the optimal clinical implementation of portal-enabled HRV elicitation and effects on person-centered oncologic care.

References: 1. Epstein AS, Desai AV, Bernal C, et al. Giving voice to patient values throughout cancer: A novel nurse-led intervention. Journal of pain and symptom management 2019, 58(1), 72-79.
2. Lynch, KA, Bernal C, Romano DR, et al. Navigating a newly diagnosed cancer through clinician-facilitated discussions of health-related patient values: A qualitative analysis. BMC palliative care 2022, 21(1), 29.
3. Epstein AS, Knezevic A, Hoque A, et al. Automated Portal-Enabled Elicitation of Health-Related Patient Values in Solid Tumor Oncology: Feasibility and Patient Characteristics Associated With Patient Response. JCO Oncology Practice 2025, OP-25.