Telemonitoring with symptom diary
Treant Hospital
Treant uses Patient Journey App to support patients during the palliative phase. By early detection of symptom burden, healthcare providers can offer patients as much quality of life as possible during the final stage of life.
Wietske Zijnge (right) is a nurse specialist in pain and palliative care, and Rinie Huitema (left) is a pain and palliative care consultant. Both work at Treant in the pain clinic and in the clinic for pain and palliative care patients.
Telemonitoring with digital symptom diary
To map out symptoms during the palliative phase, we have developed a digital symptom diary. Through Patient Journey App, the patient completes a questionnaire every two weeks. The patient rates, on a scale of 0 to 10, the extent to which they are affected by the most common symptoms experienced during the palliative phase.
Based on the responses, the patient receives advice and practical tips on the app's timeline and can indicate if they need to be contacted. As healthcare providers, we can see the answers directly in the Electronic Patient Record (EPR). We also receive a notification if the patient reports significant discomfort from one or more symptoms.
We had previously worked with an app, but it was focused solely on pain scores. While pain is the most common symptom during the palliative phase, it is not sufficient. With the symptom diary, we can offer much more to the patient as well as to ourselves as healthcare providers.
“We receive a notification if the patient indicates they are experiencing significant discomfort.”
Benefits for the patient and healthcare provider
The symptom diary gives the patient a sense of security. For instance, if we notice that a patient is experiencing a high symptom burden, we can immediately identify it. We can then contact the patient to discuss what we can do to help reduce their discomfort. It also fosters a sense of awareness in the patient. Because the app provides information about the symptoms, patients understand that it's okay to bring them up, that these symptoms are acknowledged, and that there is often something that can be done. This also gives the patient more control over their care.
“Responses are immediately visible through our Electronic Patient Record (EPR)”
For healthcare providers, there are also many benefits. Firstly, the timely detection of symptoms. For example, if a patient reports severe nausea or significant pain, we receive a notification that allows us to intervene much more quickly. Additionally, the patient’s responses are immediately visible through our Electronic Patient Record (EPR), enabling us to see their progress at a glance. This way, we can offer tailored care and collaborate with other specialisms. Lastly, it lowers the threshold for discussing the palliative phase. It becomes easier to address topics that might otherwise be overlooked, such as those you might assume are not an issue or that the patient may not want to discuss.
Reactions patients
For a few months now, the first patients have been using the app. So far, we have received feedback that the symptom diary gives them a sense of security. They appreciate the idea that there is support from the sidelines, and they feel honoured to be among the first to use the app. Patients find the information provided to be sufficient and the push notifications adequate. However, some patients feel that the language level is occasionally too complex, so we will work on this. We also receive positive feedback from caregivers, who find the app helpful. It is clear and useful for them to keep track of the patient’s progress. For example, a daughter assists her mother with completing the questionnaire when she encounters difficulties.
“Patients find it very reassuring to know that support is available from the sidelines”
Future
We are actively working on strengthening collaboration with other specialisms within Treant. Since palliative care is not confined to a single department, this remains a challenge. Additionally, it would be great to expand the app to all hospitals in the Drenthe–Groningen region, where Treant provides care, and eventually across the whole of the Netherlands. Collaboration with general practitioners is also a high priority. Even if a patient is no longer under hospital care, they should still be able to use the app, allowing healthcare providers to jointly monitor and offer care.
Content-wise, we are very satisfied. We carefully monitor the guidelines to keep the symptom diary up-to-date. Furthermore, we are particularly interested in patient feedback to determine if they find the app useful and to make improvements based on their experiences. Ultimately, it is the patients we are doing this for.
More information?
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