{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:58:17Z","timestamp":1792789097821,"version":"4.5.0"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"British Columbia Ministry of Health Innovation"},{"name":"Doctors of British Columbia Shared Care Committee and Specialist Services Committee"},{"name":"Physicians Quality Improvement Program"},{"name":"Richmond Hospital Foundation","id":[{"id":"https:\/\/ror.org\/01wm3xb93","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/01wm3xb93","id-type":"ROR","asserted-by":"publisher"}]},{"name":"British Columbia Community Oncology Trialists Group"},{"name":"Bladder Cancer Canada","id":[{"id":"https:\/\/ror.org\/01kw4hh10","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/01kw4hh10","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Pfizer","award":["75438679"],"award-info":[{"award-number":["75438679"]}],"id":[{"id":"https:\/\/ror.org\/01xdqrp08","id-type":"ROR","asserted-by":"crossref"}]},{"name":"EMD Serono","award":["75438679"],"award-info":[{"award-number":["75438679"]}],"id":[{"id":"https:\/\/ror.org\/04vpzfb52","id-type":"ROR","asserted-by":"crossref"}]},{"award":["75438679"],"award-info":[{"award-number":["75438679"]}],"id":[{"id":"https:\/\/ror.org\/04vpzfb52","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Merck"},{"name":"Johnson & Johnson"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Remote symptom monitoring using electronic patient-reported outcomes reduces symptom burden and acute care use in oncology, but most programs have been established in academic centers or funded trials using purpose-built software. We examined how the REmote Symptom and Patient mONitoring System (RESPONSe) was implemented and subsequently funded as a recurrent clinical service at a Canadian community cancer clinic using a configured commercial platform, patients\u2019 own devices, and no formal institutional mandate. We conducted a qualitative post-implementation process evaluation at Richmond Cancer Clinic, British Columbia, reported following the Consolidated Criteria for Reporting Qualitative Research. Eight staff, purposively sampled by role and phase of involvement, were invited and participated, which consisted of one oncologist, three nurses, two virtual health staff, and two administrators. Interviews were analyzed using deductive\u2013inductive thematic analysis. Three themes were identified: tailoring technology for clinical fit; designing care around patient and clinician users, centered on a dedicated symptom management nurse; and managing up towards operationalization. Operationalization was achievable using a customizable commercial platform, but depended on the interaction of iterative technology adaptation, dedicated clinical ownership, evolving care workflows, and sustained organizational advocacy. We propose five transferable implementation strategies mapped to established implementation frameworks.<\/jats:p>","DOI":"10.3390\/curroncol33090561","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:06:37Z","timestamp":1789549597000},"page":"561","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Practical Insights from Operationalizing a Remote Symptom Monitoring Program Using a Commercial Platform in a Canadian Community Cancer Clinic: A Post-Implementation Qualitative Evaluation"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3848-0241","authenticated-orcid":false,"given":"Melissa J.","family":"Chao","sequence":"first","affiliation":[{"name":"Vancouver Coastal Health, 7000 Westminster Hwy, Richmond, BC V6X 1A2, Canada"},{"name":"School of Medicine, Toronto Metropolitan University, 150 Central Park Drive, Brampton, ON L6T 2T9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"software","vocabulary":"credit"}]},{"given":"Eric","family":"Liow","sequence":"additional","affiliation":[{"name":"Vancouver Coastal Health Research Institute, 2635 Laurel Street, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Nasia A.","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Vancouver Coastal Health Research Institute, 2635 Laurel Street, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]},{"given":"Jeremy","family":"Ho","sequence":"additional","affiliation":[{"name":"Vancouver Coastal Health, 7000 Westminster Hwy, Richmond, BC V6X 1A2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref_1","first-page":"e70090","article-title":"Global cancer statistics 2024: GLOBOCAN estimates of incidence and mortality worldwide for 34 cancers in 186 countries","volume":"76","author":"Sung","year":"2026","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","first-page":"843","article-title":"Impact on daily functioning and indirect\/direct costs associated with chemotherapy-induced nausea and vomiting (CINV) in a U.S. population","volume":"19","author":"Haiderali","year":"2011","journal-title":"Support. Care Cancer"},{"key":"ref_3","first-page":"184","article-title":"Acute cancer-related symptoms and concerns among patients receiving chemotherapy: Current state of the science","volume":"32","author":"Smith","year":"2024","journal-title":"Support. Care Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2683","DOI":"10.1200\/JCO.2010.34.2816","article-title":"Why do patients with cancer visit emergency departments? Results of a 2008 population study in North Carolina","volume":"29","author":"Mayer","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/NCC.0000000000000360","article-title":"A systematic review of emergency department use among cancer patients","volume":"40","author":"Lash","year":"2017","journal-title":"Cancer Nurs."},{"key":"ref_6","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":"ref_7","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1001\/jama.2017.7156","article-title":"Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment","volume":"318","author":"Basch","year":"2017","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1830","DOI":"10.1200\/OP-24-00627","article-title":"Implementation of symptom monitoring with electronic patient-reported outcomes: Perspectives and recommendations from community oncology practices (Alliance AFT-39)","volume":"21","author":"Mody","year":"2025","journal-title":"JCO Oncol. Pract."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1038\/s41591-025-03507-y","article-title":"Symptom monitoring with electronic patient-reported outcomes during cancer treatment: Final results of the PRO-TECT cluster-randomized trial","volume":"31","author":"Basch","year":"2025","journal-title":"Nat. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1200\/OP-24-00760","article-title":"Participation in Electronic Patient-Reported Outcome Measures Collection as a Part of Routine Supportive Care Delivery in Oncology","volume":"21","author":"Katoju","year":"2025","journal-title":"JCO Oncol. Pract."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1200\/EDBK_200383","article-title":"Implementation of patient-reported outcomes in routine medical care","volume":"38","author":"Basch","year":"2018","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e259852","DOI":"10.1001\/jamanetworkopen.2025.9852","article-title":"Remote symptom monitoring with electronic patient-reported outcomes in clinical cancer populations","volume":"8","author":"Rocque","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e438512","DOI":"10.1200\/EDBK_438512","article-title":"Integrating patient-reported outcomes into the care of people with advanced cancer\u2014A practical guide","volume":"44","author":"Thorner","year":"2024","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_14","first-page":"243","article-title":"Bridging the Gap: Leveraging Digital Symptom Management to Strengthen Community Oncology Care","volume":"36","year":"2026","journal-title":"Can. Oncol. Nurs. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1200\/OP.2024.20.10_suppl.406","article-title":"Development and Implementation of a Digital Remote Symptom Monitoring Program (RESPONSe) to Support Patients Undergoing IV Chemotherapy at a Community Ambulatory Cancer Clinic in Richmond, BC, Canada","volume":"20","author":"Ho","year":"2024","journal-title":"JCO Oncol. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G","article-title":"Whatever happened to qualitative description?","volume":"23","author":"Sandelowski","year":"2000","journal-title":"Res. Nurs. Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1177\/160940690600500107","article-title":"Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development","volume":"5","author":"Fereday","year":"2006","journal-title":"Int. J. Qual. Methods"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int. J. Qual. Health Care"},{"key":"ref_19","unstructured":"Government of British Columbia, Ministry of Health (2026, August 23). Cancer Care You Can Count On: Multi-Year Policy Framework to Deliver Cancer Care in B.C., Available online: https:\/\/news.gov.bc.ca\/files\/CancerPlan2023.pdf."},{"key":"ref_20","unstructured":"Statistics Canada (2026, August 23). Census Profile, 2021 Census of Population: Richmond, City (CY), British Columbia, Available online: https:\/\/www12.statcan.gc.ca\/census-recensement\/2021\/dp-pd\/prof\/details\/page.cfm?Lang=E&DGUIDlist=2021A00055915015."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample Size in Qualitative Interview Studies: Guided by Information Power","volume":"26","author":"Malterud","year":"2016","journal-title":"Qual. Health Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/S0140-6736(09)61116-8","article-title":"No surgical innovation without evaluation: The IDEAL recommendations","volume":"374","author":"McCulloch","year":"2009","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_24","unstructured":"BC WCancer (2026, September 10). Remote Patient Monitoring Pilot Improves Access to Health Care for Immunotherapy Patients. Available online: https:\/\/www.bccancer.bc.ca\/about\/news-stories\/stories\/remote-patient-monitoring-pilot-improves-access-to-health-care-for-immunotherapy-patients."},{"key":"ref_25","unstructured":"Canadian Healthcare Technology (2026, May 26). Remote Monitoring of BC Cancer Patients. Available online: https:\/\/www.canhealth.com\/2021\/01\/13\/remote-monitoring-of-bc-cancer-patients\/."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1503\/cmaj.090808","article-title":"A country of perpetual pilot projects","volume":"180","author":"Eggertson","year":"2009","journal-title":"CMAJ"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1200\/JCO.20.02015","article-title":"Phase III randomized controlled trial of eRAPID: EHealth intervention during chemotherapy","volume":"39","author":"Absolom","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"n1647","DOI":"10.1136\/bmj.n1647","article-title":"Real time remote symptom monitoring during chemotherapy for cancer: European multicentre randomised controlled trial (eSMART)","volume":"374","author":"Maguire","year":"2021","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e19685","DOI":"10.2196\/19685","article-title":"Web-based patient-reported outcome measures for personalized treatment and care (PROMPT-Care): Multicenter pragmatic nonrandomized trial","volume":"22","author":"Girgis","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s11912-024-01534-5","article-title":"The growing role of digital health tools in the care of patients with cancer: Current use, future opportunities, and barriers to effective implementation","volume":"26","author":"Haemmerle","year":"2024","journal-title":"Curr. Oncol. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e2200187","DOI":"10.1200\/CCI.22.00187","article-title":"Tenets for implementing electronic patient-reported outcomes for remote symptom monitoring during cancer treatment","volume":"7","author":"Basch","year":"2023","journal-title":"JCO Clin. Cancer Inform."},{"key":"ref_32","unstructured":"PROTEUS Consortium (2026, May 26). The PROTEUS Guide to Implementing Patient-Reported Outcomes in Clinical Practice: A Synthesis of Resources. PROTEUS Consortium. Available online: https:\/\/theproteusconsortium.org\/wp-content\/uploads\/2023\/04\/PROTEUS-Practice-Guide.pdf."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s13012-022-01245-0","article-title":"The updated Consolidated Framework for Implementation Research based on user feedback","volume":"17","author":"Damschroder","year":"2022","journal-title":"Implement. Sci."},{"key":"ref_34","unstructured":"University of British Columbia (2009). VCHRI Quality Assurance\/Quality Improvement (QA\/QI) Checklist, University of British Columbia. Available online: https:\/\/researchethics.ubc.ca\/sites\/default\/files\/documents\/VCHRI_QA_QI_checklist.pdf."},{"key":"ref_35","unstructured":"University of British Columbia (2022). Guidance Notes: Behavioural Research Ethics Board (BREB) Application, University of British Columbia. Available online: https:\/\/researchethics.ubc.ca\/behavioural-research-ethics\/breb-guidance-notes\/guidance-notes-behavioural-application."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/9\/561\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:20:55Z","timestamp":1789705255000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/9\/561"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["curroncol33090561"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33090561","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]}}}