Customizing workflows for electronic patient-reported outcome (ePRO) symptom monitoring using the action, actor, context, target, time (AACTT) framework
- Author(s)
- Lai-Kwon, J; Rutherford, C; Jefford, M; Zhang, I; Devereux, C; Herath, D; Burbury, K; Best, S;
- Journal Title
- Quality of Life Research
- Publication Type
- Online publication before print
- Abstract
- BACKGROUND: Real-time electronic patient-reported outcome (ePRO) symptom monitoring is a complex intervention with few examples of successful implementation at scale. A key challenge is designing a clear ePRO symptom monitoring workflow to support implementation into practice. We aimed to create an empirical and theory-informed site-specific workflow guided by the Action, Actor, Context, Target, Time (AACTT) implementation science framework. METHODS: A five-step process was undertaken to customize a generic ePRO symptom monitoring workflow to create a site-specific version: (1) design a generic ePRO symptom monitoring workflow through a qualitative study with key stakeholders; (2) conduct co-design workshops to understand stakeholder preferences regarding a site-specific version; (3) code co-design workshop data using the AACTT framework to produce a provisional site-specific version; (4) conduct a final co-design workshop using the AACTT framework to finalize stakeholder preferences for a site-specific version; and (5) code co-design workshop data using the AACTT framework to produce a final site-specific version. RESULTS: Participants (n = 27) included nine patients, four caregivers, four oncologists, four nurses, two pharmacists, two clinic administrators, and two Electronic Medical Record (EMR) analysts. Provisional and final site-specific workflows were generated outlining the key AACTT components for each step of ePRO symptom monitoring. CONCLUSION: We demonstrated the value in using the AACTT to guide the co-design of a site-specific workflow for ePRO symptom monitoring. By describing this process in detail, we will enable others to replicate this process for creating site-specific workflows not only for ePRO symptom monitoring, but for any complex clinical process.
- Keywords
- AACTT framework; Implementation science; Patient-reported outcomes; Symptom monitoring; Workflows
- Department(s)
- Medical Oncology; Health Services Research; Australian Cancer Survivorship Centre; Digital and Healthcare Innovation
- Publisher's Version
- https://doi.org/10.1007/s11136-025-03995-y
- Open Access at Publisher's Site
https://doi.org/10.1007/s11136-025-03995-y- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-06-26 04:30:30
Last Modified: 2025-06-26 04:31:07