Improving Care for Gynecologic Cancers Through Patient Reported Outcomes

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In this video, Rachel Sisodia, MD, a gynecologic oncologist in the Center for Gynecologic Oncology at the Massachusetts General Hospital Cancer Center, gynecologic surgeon at Massachusetts General Hospital, medical director of the Mass General Physicians Organization, and medical director of Patient Reported Outcomes at Mass General Brigham, discusses how incorporating the patient's voice into their care via patient-reported outcomes can improve their care journey and health outcomes. Her research is focused in perioperative outcomes for women with gynecologic malignancies, particularly as it relates to patient-reported outcomes.

Transcript

My research currently is focused in perioperative outcomes for women with gynecologic malignancies, particularly as it relates to patient-reported outcomes. Patient-reported outcomes are essentially where we try to incorporate the patient's voice into their care. Modern medicine is very good at measuring things that matter to us: 30-day reinfection rates, trips to the ICU, unplanned surgical reoperations. However, most of the time I never have a patient say to me, "I'm so glad I didn't go to the ICU," and so we're trying to focus more now on the things that matter to patients, such as, "Am I able to play with my grandchildren?" or "Am I able to go back to work?" Through patient-reported outcomes, we can also assess differences in surgical technique and surgical quality, differences in hospital quality assumptions and [get] a better understanding of which treatments expose the patients to the best outcomes with the least amount of morbidity.

Patient-reported outcomes have been around for a long time but there is much more interest in them as of late. There have been several studies that have shown that routine collection of patient-reported outcomes as well as just frankly acting on them in a common-sense fashion improves not just quality of life, but length of life.

There was a study that came out of patients with metastatic malignancy which essentially showed that in patients who had patient-reported outcomes collected they had at least a six-month extension in their overall survival, which if you put that in comparison to any of our new biologic agents or immunotherapies, it is essentially far superior through something without much capital outlay or much infrastructure required.

We have realized in patient-reported outcomes in gynecologic malignancy that many of our patients who present for care also have over-arching social themes that will permeate their whole care transition. For example, many of the women that will come in will identify on a validated questionnaire that they have no one to take them to their doctors' appointments when they fall sick, or that they have no one who can go get a prescription filled for them. If we can identify that early on, we can appropriately refer those patients to Social Work, who can then follow them throughout their care journey, ensuring they get the best care.

Here in Gynecologic Oncology, we're looking forward to doing a pilot trial where we take patients with malignancy that flag positive for these social stressors and partner with one of our local philanthropic groups to provide them with support throughout their care journey. If we compare patients that appear vulnerable from a socioeconomic perspective when they are first diagnosed with cancer and then compare them to their more affluent colleagues, we notice health care disparities throughout the care trajectory. We are hoping that by using patient-reported outcomes to identify these patients, we can bolster their care with appropriate resources and make their outcomes equivalent.

Learn more about the Center for Gynecologic Oncology

Refer a patient to the Center for Gynecologic Oncology