IMPROVE - patient experience in cancer network as healthcare system decision metrics

Abstract Background The application of digital transformation in the Apulian Cancer Network (CN) identified Orientation Cancer Centers (COrOs) and Breast Units (BU) as key access points. This retrospective analysis, conducted within the IMPROVE project, explores value-based data and evaluates the potential use of PROs (PREMs and PROMs) as tools to assess patient experience in the CN and guide system decisions. Methods The analysis involved 18 COrOs and 11 of 13 BUs, from January 2022 to March 2025 (38 months). We assessed: • The number of patients taken in charge via COrOs and BUs and enrolled in the digital platform (quantitative analysis) to evaluate digital literacy. • Value-based indicators collected (qualitative analysis) to design the prospective phase using PROs as care metrics. Results A total of 21552 patients were enrolled in the CN platform: 81% via COrOs (N = 17,357; non-breast cancer) and 19% via BUs (N = 4195). In the elderly population (>80 yrs: 60.3%; 80-85: 27.4%; >85: 11.4%), G8 scores (1-14 scale assessing need for geriatric evaluation) were 7-10.5 in 7.6% and 10.5-14 in 44%. Key findings: • Reduced food intake: mild 11.2%, severe 3.6%; • Decreased BMI: mild 4.5%, severe 2.3%; • Reduced mobility: 17.1%; • >3 daily medications: 58.3%; • Neuro-cognitive issues or depression: 12.3%; • Local social services involved: 0.42%; • Alcohol dependence: 1%; • Recurrent cancer family history: 53%. CN access was through general practitioners in 55% and internal specialists in 44% of cases. Conclusions Digital transformation identifies health needs for better planning: from elderly to younger patients, from breast cancer to other tumors, highlighting social frailty, polypharmacy, and system accessibility. The IMPROVE tool, through PROs, can integrate patient perspectives into decision-making. Key messages • Digital transformation as a driver for healthcare planning in the cure of cancer. • Voice pf patient (PROs) as decision metric in cancer care.