Innovating Cancer Care through Remote Patient Monitoring

Enabling Access to Care Anywhere Using the My Bowels On Track (MBOT) App

The My Bowels On Track (MBOT) app was created to digitally optimize the Malignant Bowel Obstruction (MBO) Proactive Call Program in the Gynecological Cancer Clinic by monitoring and prioritizing calls to patients with serious symptoms. Patients utilized the app to report symptoms online and their responses automatically triaged based on severity.

The MBOT app increased the number of patients monitored and reduced nursing workload on proactive calls with 100% of nurses reporting that they would use an electronic monitoring service again. The app also included resources to teach, support and empower patients in the self-management of MBO symptoms. By collaborating with patients and providers (Dr. Stephanie Lheureux, Dr. Ainhoa Madariaga, and Nazlin Jivraj), CDI ensured that the app met the needs of the clinic and patients and was easy-to-use.

“I love that the app has many resources at your fingertips,” says a patient of the MBOT program. “It is a user-friendly app. I can contact my nurse and team very quickly and communicate with them through text. I love the quick access to my team.”

60 patients supported by the remote patient monitoring app, MBOT

Collaborative Co-Design Leads to Effective Remote Monitoring Program for Melanoma Patients

Actively monitoring patients on immunotherapy in the Melanoma/Skin Oncology (MSO) clinic is essential to avoid adverse events in patients and urgent hospital visits. To support the MSO clinic’s nurse-led proactive monitoring program, CDI collaborated with providers (Dr. Marcus Butler, Dr. Mauricio Ribeiro, and Nancy Gregorio) and patients to co-design a digital remote monitoring program (eIMBRASE). This app-based program makes it easier and more efficient for nurses to follow-up with patients, track symptoms, and prioritize in-person assessments for patients at risk of an adverse event.

In the eIMBRASE program, patients wear discrete biometric devices and complete scheduled electronic patient-reported outcomes (ePROs) questionnaires that are delivered directly to their mobile device of choice. The real-time biometrics and ePROs data are prioritized by an algorithm that accounts for the number of symptoms, changes in symptoms, and the symptom’s strength of association with the treatment type.

The algorithm generates alerts for care teams displayed on a clinical dashboard and designates a priority-oriented timeframe for contacting patients at risk of adverse events. To co-develop this prioritization algorithm, CDI conducted in-clinic shadowing, used sample case worksheets, and completed algorithm simulations to translate clinical practices and processes into the factors considered for prioritization.

Working closely with care providers, patients, and technology partners to co-design the user interfaces and the workflows, eIMBRASE illustrates the potential for digital health technologies to create a program that benefits both patients and providers. Following the design of the digital remote monitoring program, CDI is launching a pilot to assess its feasibility and measure its impact on patient and provider outcomes and satisfaction.