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My Wellness Check FAQs

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My Wellness Check FAQs

What is My Wellness Check? Page 1

My Wellness Check is a program that monitors patient-reported outcomes (PROs), such as psychosocial distress, physical symptoms, and psychosocial, practical, and nutrition needs in ambulatory oncology patients. These PROs and needs are assessed via the MyUHealth Chart portal and are scored and populated in real-time in the patient’s electronic health record.

What types of symptoms and needs does My Wellness Check assess? Page 1

The system assesses physical symptoms, psychosocial symptoms, nutrition needs, and practical needs.

How does My Wellness Check work? Page 1

A request to complete the assessment is sent via MyChart to adult patients with a cancer diagnosis 72 hours before their scheduled appointment. Best practice alerts (BPAs) automatically appear in EPIC for patients who endorse clinically elevated symptoms or report a need. Assessments are tied to appointments and take place no more than once every 30 days.

Who responds to the My Wellness Check alerts? Page 1

Relevant provider teams, such as social work, medical, and nutrition teams, are alerted in real-time via EPIC and asked to select a disposition based on the stated need or elevated score.

What are PROMIS Measures? Page 1

The Patient-Reported Outcomes Measurement Information System (PROMIS) is an NIH-funded initiative that has developed and validated patient-reported outcomes (PROs) for clinical research and practice. It includes a set of measures that evaluate and monitor physical, mental, and psychosocial health in adults and children. My Wellness Check uses PROMIS computerized assessment tests (CATs) to assess anxiety, depression, pain, fatigue, and physical function.

What are PROMIS Computer Adaptive Tests (CATS)? Page 1

PROMIS Computer Adaptive Tests are brief, interactive assessment tools that tailor a person's questions depending on their responses. Scores within a specific range will trigger a best practice alert.

Are PROMIS CATS relevant to an oncology population? Page 1

Yes. PROMIS CATs are brief, well-validated, and clinically relevant measures that can assess various PROs in cancer patients and survivors and provide actionable data to guide clinical practice.

Why do some questions seem redundant? Page 1

Redundancy in several items is necessary to calculate the CAT score and establish a response pattern.

How were the alert thresholds for each symptom or domain determined? Page 1

PROMIS CATs generate T-scores with clinically validated cutoffs based on normative data from cancer patients and the general population.

How is the data collected used? Page 1

Data generated will be used to assist care providers in delivering precision and patient-centered care. My Wellness Check also meets accreditation requirements set by the American College of Surgeons, Commission on Cancer (COC) 2020 Standards, Section 5.2.

Why use the PROMIS CATs over the Distress Thermometer? Page 1

The single-item Distress Thermometer is a quick and easy tool but not always sufficient because it lacks sensitivity and specificity—it can yield a high rate of false positives or false negatives. The PROMIS tool provides greater accuracy in identifying relevant cancer-related distress.

As an administrator, how can I use My Wellness Check metrics? Page 1

My Wellness Check can provide metrics specific to patient’s distress, practical needs, and nutritional needs, thus assisting administrators in projecting and allocating necessary resources to meet the needs of our ambulatory oncology patients. The program also provides opportunities to optimize clinical workflows, evaluate how the identification of patients’ needs and appropriate referrals impact system-level outcomes, including care costs.

Where can I offer feedback and suggestions about the current system? Page 1

Contact the My Wellness Check team at MyWellnessCheck@med.miami.edu.

Can my patients receive a text message reminder to complete My Wellness Check? Page 1

Yes. In the patient portal, patients can choose text messages as their preferred mode of communication from UHealth.

How can patients complete the screener if they don’t have a MyChart account? Page 1

Since the My Wellness Check was designed as an electronic health record (EHR) integrated screening and referral model, it is recommended that a patient have a MyChart account to complete the screener. However, a patient without a MyChart account may complete My Wellness Check with the assistance of our clinic teams.

What metrics are available for clinics and clinicians to see? Page 1

PROMIS measures use a T-score metric in which 50 is the mean of a relevant reference population and 10 is the standard deviation (SD) of that population. Patients with PROMIS T-scores falling within 'moderate' or 'severe' thresholds will trigger an alert to the appropriate care team for triaging. In addition to physical and psychosocial symptoms, providers are also able to monitor and track a patient's practical and nutritional needs in the EHR over time.

What are the research initiatives aligned with this work? Page 1

Currently, My Wellness Check is a quality improvement project. However, once the program is implemented systemwide, research opportunities will be available (which will require IRB protocol submissions and approval) to assess the impact of the program at the patient- and system-level.

What can I find in the published literature to support this work? Page 1

Garcia SF, Wortman K, Cella D, Wagner LI, Bass M, Kircher S, Pearman T, Penedo FJ. Implementing electronic health record-integrated screening of patient-reported symptoms and supportive care needs in a comprehensive cancer center. Cancer. 2019 Nov 15;125(22):4059-4068. doi: 10.1002/cncr.32172. Epub 2019 Aug 2. PMID: 31373682.

Penedo FJ, Oswald LB, Kronenfeld JP, Garcia SF, Cella D, Yanez B. The increasing value of eHealth in the delivery of patient-centered cancer care. Lancet Oncol. 2020 May;21(5):e240-e251. doi: 10.1016/S1470-2045(20)30021-8. PMID: 32359500.

Pearman T, Garcia S, Penedo F, Yanez B, Wagner L, Cella D. Implementation of distress screening in an oncology setting. J Community Support Oncol. 2015 Dec;13(12):423-8. doi: 10.12788/jcso.0198. PMID: 26863872.

How do I get trained to use My Wellness Check? Page 1

A training guide and modules are available upon request by contacting Vandana Sookdeo, MD, Administrative Director of Clinical Programs, at v.sookdeo@med.miami.edu or MyWellnessCheck@med.miami.edu.

Who do I contact if I have questions or problems? Page 1

Contact Vandana Sookdeo, M.D., Administrative Director of Clinical Programs, at v.sookdeo@med.miami.edu or MyWellnessCheck@med.miami.edu.

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