{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T08:46:33Z","timestamp":1776156393588,"version":"3.50.1"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T00:00:00Z","timestamp":1600905600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centre for Epidemiology Versus Arthritis","award":["21755"],"award-info":[{"award-number":["21755"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n People with long-term conditions require serial clinical assessments. Digital patient-reported symptoms collected between visits can inform these, especially if integrated into electronic health records (EHRs) and clinical workflows. This systematic review identified and summarized EHR-integrated systems to remotely collect patient-reported symptoms and examined their anticipated and realized benefits in long-term conditions.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n We searched Medline, Web of Science, and Embase. Inclusion criteria were symptom reporting systems in adults with long-term conditions; data integrated into the EHR; data collection outside of clinic; data used in clinical care. We synthesized data thematically. Benefits were assessed against a list of outcome indicators. We critically appraised studies using the Mixed Methods Appraisal Tool.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We included 12 studies representing 10 systems. Seven were in oncology. Systems were technically and functionally heterogeneous, with the majority being fully integrated (data viewable in the EHR). Half of the systems enabled regular symptom tracking between visits. We identified 3 symptom report-guided clinical workflows: Consultation-only (data used during consultation, n\u2009=\u20095), alert-based (real-time alerts for providers, n\u2009=\u20094) and patient-initiated visits (n\u2009=\u20091). Few author-described anticipated benefits, primarily to improve communication and resultant health outcomes, were realized based on the study results, and were only supported by evidence from early-stage qualitative studies. Studies were primarily feasibility and pilot studies of acceptable quality.<\/jats:p>\n <\/jats:sec>\n \n Discussion and Conclusions<\/jats:title>\n EHR-integrated remote symptom monitoring is possible, but there are few published efforts to inform development of these systems. Currently there is limited evidence that this improves care and outcomes, warranting future robust, quantitative studies of efficacy and effectiveness.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/jamia\/ocaa177","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T19:22:20Z","timestamp":1595445740000},"page":"1752-1763","source":"Crossref","is-referenced-by-count":77,"title":["Remote symptom monitoring integrated into electronic health records:\u00a0A systematic review"],"prefix":"10.1093","volume":"27","author":[{"given":"Julie","family":"Gandrup","sequence":"first","affiliation":[{"name":"Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK"}]},{"given":"Syed Mustafa","family":"Ali","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK"}]},{"given":"John","family":"McBeth","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK"},{"name":"NIHR Greater Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK"}]},{"given":"Sabine N","family":"van der Veer","sequence":"additional","affiliation":[{"name":"Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK"}]},{"given":"William G","family":"Dixon","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK"},{"name":"NIHR Greater Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK"},{"name":"Rheumatology Department, Salford Royal NHS Foundation Trust, Salford, UK"}]}],"member":"286","published-online":{"date-parts":[[2020,9,23]]},"reference":[{"key":"2020111714264502700_ocaa177-B1","doi-asserted-by":"publisher","year":"2009","DOI":"10.1037\/e581002012-001"},{"key":"2020111714264502700_ocaa177-B2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15040781","article-title":"Mapping European welfare models: state of the art of strategies for professional integration and reintegration of persons with chronic diseases","volume":"15","author":"Scaratti","year":"2018","journal-title":"Int J Environ Res Public Health"},{"issue":"10159","key":"2020111714264502700_ocaa177-B3","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(18)32279-7","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"392","author":"James","year":"2018","journal-title":"Lancet"},{"key":"2020111714264502700_ocaa177-B4","year":"2014"},{"key":"2020111714264502700_ocaa177-B5","author":"Shapiro","year":"2012"},{"issue":"1","key":"2020111714264502700_ocaa177-B6","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/1472-6963-13-211","article-title":"A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting","volume":"13","author":"Chen","year":"2013","journal-title":"BMC Health Serv Res"},{"issue":"3","key":"2020111714264502700_ocaa177-B7","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/BOR.0000000000000485","article-title":"Using technology to support clinical care and research in rheumatoid arthritis","volume":"30","author":"Dixon","year":"2018","journal-title":"Curr Opin Rheumatol"},{"issue":"6","key":"2020111714264502700_ocaa177-B8","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1093\/jamia\/ocy006","article-title":"Converging and diverging needs between patients and providers who are collecting and using patient-generated health data: an integrative review","volume":"25","author":"Reading","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"4","key":"2020111714264502700_ocaa177-B9","doi-asserted-by":"crossref","first-page":"254","DOI":"10.14236\/jhi.v25i4.1068","article-title":"Five key strategic priorities of integrating patient generated health data into United Kingdom electronic health records","volume":"25","author":"Cresswell","year":"2018","journal-title":"BMJ Health Care Inform"},{"issue":"2","key":"2020111714264502700_ocaa177-B10","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.2196\/humanfactors.5919","article-title":"Integrating patient-generated health data into clinical care settings or clinical decision-making: lessons learned from project HealthDesign","volume":"3","author":"Cohen","year":"2016","journal-title":"JMIR Hum Factors"},{"key":"2020111714264502700_ocaa177-B11","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.ijmedinf.2017.02.008","article-title":"Clinical impact and value of workstation single sign-on","volume":"101","author":"Gellert","year":"2017","journal-title":"Int J Med Inf"},{"key":"2020111714264502700_ocaa177-B12","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"issue":"3","key":"2020111714264502700_ocaa177-B13","article-title":"Personalised care planning for adults with chronic or long-term health conditions","volume":"2015","author":"Coulter","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"2020111714264502700_ocaa177-B14","doi-asserted-by":"crossref","first-page":"e10875","DOI":"10.2196\/10875","article-title":"Electronic systems for patients to report and manage side effects of cancer treatment: systematic review","volume":"21","author":"Warrington","year":"2019","journal-title":"J Med Internet Res"},{"issue":"1","key":"2020111714264502700_ocaa177-B15","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1089\/tmj.2016.0051","article-title":"Remote patient monitoring via non-invasive digital technologies: a systematic review","volume":"23","author":"Vegesna","year":"2017","journal-title":"Telemed J E-Health"},{"issue":"9","key":"2020111714264502700_ocaa177-B16","doi-asserted-by":"crossref","first-page":"e12861","DOI":"10.2196\/12861","article-title":"Wearable health technology and electronic health record integration: scoping review and future directions","volume":"7","author":"Dinh-Le","year":"2019","journal-title":"JMIR MHealth UHealth"},{"key":"2020111714264502700_ocaa177-B17","first-page":"1","article-title":"Impact of remote patient monitoring on clinical outcomes: an updated meta-analysis of randomized controlled trials","volume":"1","author":"Noah","year":"2018","journal-title":"NPJ Digit Med"},{"issue":"01","key":"2020111714264502700_ocaa177-B18","doi-asserted-by":"crossref","first-page":"306","DOI":"10.4338\/ACI-2016-10-CR-0171","article-title":"Implementation of a single sign-on system between practice, research and learning systems","volume":"26","author":"Purkayastha","year":"2017","journal-title":"Appl Clin Inform"},{"issue":"1","key":"2020111714264502700_ocaa177-B19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ijnurstu.2011.07.002","article-title":"Testing the reliability and efficiency of the pilot Mixed Methods Appraisal Tool (MMAT) for systematic mixed studies review","volume":"49","author":"Pace","year":"2012","journal-title":"Int J Nurs Stud"},{"key":"2020111714264502700_ocaa177-B20","article-title":"Providing \u201cthe bigger picture\u201d: benefits and feasibility of integrating remote monitoring from smartphones into the electronic health record","author":"Austin","year":"2019","journal-title":"Rheumatology"},{"issue":"1","key":"2020111714264502700_ocaa177-B21","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s41687-019-0151-0","article-title":"Patient-initiated versus fixed-interval patient-reported outcome-based follow-up in outpatients with epilepsy: a pragmatic randomized controlled trial","volume":"3","author":"Schougaard","year":"2019","journal-title":"J Patient Rep Outcomes"},{"key":"2020111714264502700_ocaa177-B22","doi-asserted-by":"crossref","DOI":"10.1186\/s41687-018-0059-0","article-title":"Patient reported outcomes\u2013experiences with implementation in a university health care setting","volume":"2.","author":"Biber","year":"2018","journal-title":"J Patient-Rep Outcomes"},{"issue":"4","key":"2020111714264502700_ocaa177-B23","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1002\/pon.3087","article-title":"Feasibility and value of PatientViewpoint: a web system for patient-reported outcomes assessment in clinical practice","volume":"22","author":"Snyder","year":"2013","journal-title":"Psychooncology"},{"issue":"3","key":"2020111714264502700_ocaa177-B24","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s11136-015-1207-0","article-title":"AmbuFlex: tele-patient-reported outcomes (telePRO) as the basis for follow-up in chronic and malignant diseases","volume":"25","author":"Schougaard","year":"2016","journal-title":"Qual Life Res"},{"issue":"22","key":"2020111714264502700_ocaa177-B25","doi-asserted-by":"crossref","first-page":"4059","DOI":"10.1002\/cncr.32172","article-title":"Implementing electronic health record-integrated screening of patient-reported symptoms and supportive care needs in a comprehensive cancer center","volume":"125","author":"Garcia","year":"2019","journal-title":"Cancer"},{"issue":"7","key":"2020111714264502700_ocaa177-B26","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/j.ejso.2019.01.007","article-title":"Implementation of value-based breast cancer care","volume":"45","author":"van Egdom","year":"2019","journal-title":"Eur J Surg Oncol"},{"issue":"6","key":"2020111714264502700_ocaa177-B27","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1002\/cncr.29104","article-title":"Bringing PROMIS to practice: brief and precise symptom screening in ambulatory cancer care","volume":"121","author":"Wagner","year":"2015","journal-title":"Cancer"},{"issue":"4","key":"2020111714264502700_ocaa177-B28","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s11764-018-0682-z","article-title":"Use of a web-based app to improve breast cancer symptom management and adherence for aromatase inhibitors: a randomized controlled feasibility trial","volume":"12","author":"Graetz","year":"2018","journal-title":"J Cancer Surviv"},{"issue":"1","key":"2020111714264502700_ocaa177-B29","doi-asserted-by":"crossref","first-page":"e025185","DOI":"10.1136\/bmjopen-2018-025185","article-title":"Online tool for monitoring adverse events in patients with cancer during treatment (eRAPID): field testing in a clinical setting","volume":"9","author":"Warrington","year":"2019","journal-title":"BMJ Open"},{"key":"2020111714264502700_ocaa177-B30","article-title":"Collection of electronic patient-reported symptoms in patients with advanced cancer using Epic MyChart surveys","author":"Zylla","year":"2019","journal-title":"Support Care Cancer"},{"issue":"10","key":"2020111714264502700_ocaa177-B31","doi-asserted-by":"crossref","first-page":"e330","DOI":"10.2196\/jmir.8360","article-title":"eHealth System for Collecting and Utilizing Patient Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) among cancer patients: mixed methods approach to evaluate feasibility and acceptability","volume":"19","author":"Girgis","year":"2017","journal-title":"J Med Internet Res"},{"issue":"14","key":"2020111714264502700_ocaa177-B32","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1200\/JCO.2013.53.5948","article-title":"What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials","volume":"32","author":"Kotronoulas","year":"2014","journal-title":"J Clin Oncol"},{"key":"2020111714264502700_ocaa177-B33"},{"issue":"7","key":"2020111714264502700_ocaa177-B34","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1093\/jamia\/ocz039","article-title":"Bridging the integration gap between patient-generated blood glucose data and electronic health records","volume":"26","author":"Lewinski","year":"2019","journal-title":"J Am Med Inform Assoc"},{"issue":"9","key":"2020111714264502700_ocaa177-B35","doi-asserted-by":"crossref","first-page":"e311","DOI":"10.2196\/jmir.7831","article-title":"Personalized hypertension management using patient-generated health data integrated with electronic health records (EMPOWER-H): six-month pre-post study","volume":"19","author":"Lv","year":"2017","journal-title":"J Med Internet Res"},{"key":"2020111714264502700_ocaa177-B36","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1038\/s41746-018-0030-8","article-title":"From smartphone to EHR: a case report on integrating patient-generated health data","volume":"1","author":"Genes","year":"2018","journal-title":"NPJ Digit Med"},{"issue":"10","key":"2020111714264502700_ocaa177-B37","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1093\/jamia\/ocy054","article-title":"A visual analytics approach for pattern-recognition in patient-generated data","volume":"25","author":"Feller","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"2020111714264502700_ocaa177-B38","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/jamia\/ocx042","article-title":"The impact of home care nurses\u2019 numeracy and graph literacy on comprehension of visual display information: implications for dashboard design","volume":"25","author":"Dowding","year":"2018","journal-title":"J Am Med Inform Assoc"},{"key":"2020111714264502700_ocaa177-B39","year":"2019"},{"issue":"6","key":"2020111714264502700_ocaa177-B40","doi-asserted-by":"crossref","first-page":"e232","DOI":"10.2196\/jmir.7126","article-title":"Developing and evaluating digital interventions to promote behavior change in health and health care: recommendations resulting from an international workshop","volume":"19","author":"Michie","year":"2017","journal-title":"J Med Internet Res"},{"issue":"6","key":"2020111714264502700_ocaa177-B41","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1200\/JCO.2015.63.0830","article-title":"Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial","volume":"34","author":"Basch","year":"2016","journal-title":"J Clin Oncol"},{"issue":"10","key":"2020111714264502700_ocaa177-B42","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1056\/NEJMra1806949","article-title":"Mobile devices and health","volume":"381","author":"Sim","year":"2019","journal-title":"N Engl J Med"},{"issue":"5","key":"2020111714264502700_ocaa177-B43","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1093\/jamia\/ocv189","article-title":"SMART on FHIR: a standards-based, interoperable apps platform for electronic health records","volume":"23","author":"Mandel","year":"2016","journal-title":"J Am Med Inform Assoc"},{"key":"2020111714264502700_ocaa177-B44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41746-020-0218-6","article-title":"SMART Markers: collecting patient-generated health data as a standardized property of health information technology","volume":"3","author":"Sayeed","year":"2020","journal-title":"NPJ Digit Med"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/27\/11\/1752\/34363857\/ocaa177.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/27\/11\/1752\/34363857\/ocaa177.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T19:28:16Z","timestamp":1605641296000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/27\/11\/1752\/5910715"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,23]]},"references-count":44,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,9,23]]},"published-print":{"date-parts":[[2020,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocaa177","relation":{},"ISSN":["1527-974X"],"issn-type":[{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11]]},"published":{"date-parts":[[2020,9,23]]}}}