Quality of Life Trajectories With Integration Into Electronic Health Records for High-Resolution Patient Outcomes: Algorithm Development and Validation Study

BACKGROUND: Patient-reported outcome measures (PROMs) such as health-related quality of life (HRQoL) are usually assessed at greater time intervals such as diagnostic time points, after treatment, and during follow-up. Many PROMs require frequent data collection (weekly or daily). Electronic PROMs enable high-resolution tracking but face declining response rates. Integrating PROMs into electronic health records (EHRs) could improve response rates and personalize therapy. OBJECTIVE: This study aimed to evaluate the technical and clinical feasibility of high-frequency HRQoL assessments for routine care in EHRs. METHODS: Patients receive emails on their mobile devices with 1-time links to a web-based app called MyEDC. This app communicates with an electronic data capture proxy in the demilitarized zone of the hospital. With a polling mechanism, these patient data are transferred to the protected hospital network and uploaded to the EHR system. HRQoL on a visual analog scale is assessed over the course of treatment in 4 clinical use cases: psychosomatics, hematology, visceral surgery, and neurosurgery. RESULTS: Quality of life (QoL) trajectories were collected for 110 patients with daily or weekly data collection between 2 weeks and 3 months. The HRQoL analyses revealed clinically relevant findings across the 4 different medical domains. In the use case psychosomatics, 36 patients showed a significant increase in HRQoL following 4 weeks of therapy, rising from a median of 42% (IQR 32%-52%) to 60% (IQR 41%-67%; P=.01). An analysis of 25 patients in hematology demonstrated a significant correlation between HRQoL and 30-item QoL Questionnaire (EORTC QLQ-C30) global health status score (P=.02). For 26 patients in visceral surgery, a significant association was observed between HRQoL and the reported pain level (P