Ms Jane Stewart1, Ms Karli Vanvitelli2, Ms Carrie Service3, Ms Kate Graham1, Ms Jenelle Loeliger1, Ms Keryn Coster2, Ms Hilda Griffin3, Ms Kath Feely4,5,6
1Nutrition & Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Australia, 2Nutrition & Food Services Department, Royal Children's Hospital, Melbourne, Australia, 3Clinical Nutrition Department, Royal Melbourne Hospital, Melbourne, Australia, 4Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia, 5Allied Health, Royal Children's Hospital, Melbourne, Australia, 6Allied Health, Royal Melbourne Hospital, Melbourne, Australia
Biography:
Jane is an Accredited Practicing Dietitian and has worked as a clinical dietitian in a range of settings in both Australia and the UK for the past 25 years. Jane is the clinical lead dietitian and leads the home enteral nutrition and PEG service at Peter MacCallum Cancer Centre, Melbourne. Jane has a passion for improving the nutritional care of cancer patients and has been actively involved in the Victorian Cancer Malnutrition Collaborative program of work since 2016. She has also contributed to the development and dissemination of COSA’s position statement on cancer-related malnutrition and sarcopenia.
Abstract:
Purpose:
To report on the feasibility and clinical utility of a novel remote monitoring model of care for home enteral nutrition (HEN).
Problem:
Nutrition departments at Peter MacCallum Cancer Centre, Royal Melbourne Hospital and Royal Children’s Hospital manage approximately 1000 patients requiring HEN at any one time. A remote monitoring model of care using an app-based patient portal was co-designed. The platform enables HEN patients to input clinical data which triggers escalation of care if required, access individualised education resources, order HEN supplies and request clinician call-back. A pilot of this model of care was required to determine usability and acceptability.
Outcome:
Feasibility and clinical utility testing were conducted in 2023 (n=73). Evaluation included patient/carer surveys at three time points (baseline, two and six months) incorporating patient-reported outcomes, health and digital health literacy tools, System Usability Scale and Unified Theory of Acceptance and Use of Technology. Results indicate above average usability, high acceptability, and low privacy concerns.
Focus groups with patients/carers (n=7) and health professionals (n=21) were conducted to further investigate user experience. Preliminary themes support remote monitoring for HEN patients, however, indicate that age and technology literacy of patients should be considered. Success of this model of care relies on integration with existing workflows and adequate training for staff. Further optimisation is required to improve user experience.
Conclusion:
The remote monitoring model of care for HEN patients is feasible and well accepted by patients. Optimisation is underway prior to expanding use across our HEN population.