University of Oulu

Laitio, A.-M., Giunti, G., & Halonen, R. (2023). Perceived Barriers and Facilitators in Using Patient-Reported Outcome Systems for Cancer Care: Systematic Mapping Study:. JMIR Cancer, 9, e40875.

Perceived barriers and facilitators in using patient-reported outcome systems for cancer care : systematic mapping study

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Author: Laitio, Anna-Mari1; Giunti, Guido2,3; Halonen, Raija1
Organizations: 1Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
2Faculty of Medicine, University of Oulu, Oulu, Finland
3School of Medicine, Trinity College Dublin, Dublin, Ireland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
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Language: English
Published: JMIR Publications, 2023
Publish Date: 2023-09-26


Background: Cancer is a major global health problem. Patient-reported outcome (PRO) systems have been developed to support the treatment of patients with cancer. Although clear evidence of the benefits of the routine use of electronic patient-reported outcomes (ePROs) exists, engaging physicians in using these systems has been challenging.

Objective: This study aims to identify and analyze what is currently known about health care professionals’ (HCPs) perceived barriers and facilitators that exist and influence the use of ePRO systems for cancer care.

Methods: We carried out a systematic mapping study by conducting searches of 3 databases (Association for Computing Machinery, PubMed, and Scopus). Eligible papers were published between 2010 and 2021, and they described HCPs’ perspectives on using ePROs. The data on the included papers were extracted, a thematic meta-synthesis was performed, and 7 themes were summarized into 3 categories.

Results: A total of 17 papers were included in the study. The HCPs’ perceived barriers and facilitators of using ePROs can be summarized into 7 themes: clinical workflow, organization and infrastructure, value to patients, value to HCPs, digital health literacy, usability, and data visualization and perceived features. These themes can be further summarized into 3 categories: work environment, value to users, and suggested features. According to the study, ePROs should be interoperable with hospital electronic health records and adapted to the hospital workflow. HCPs should get appropriate support for their use. Additional features are needed for ePROs, and special attention should be paid to data visualization. Patients should have the option to use web-based ePROs at home and complete it at the time most valuable to the treatment. Patients’ ePRO notes need attention during clinical visits, but ePRO use should not limit patient-clinician face-to-face communication.

Conclusions: The study revealed that several aspects need improvement in ePROs and their operating environments. By improving these aspects, HCPs’ experience with ePROs will enhance, and thus, there will be more facilitating factors for HCPs to use ePROs than those available today. More national and international knowledge about using ePROs is still needed to cover the need for information to develop them and their operating environments to meet the needs of HCPs.

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Series: JMIR cancer
ISSN: 2369-1999
ISSN-E: 2369-1999
ISSN-L: 2369-1999
Volume: 9
Article number: e40875
DOI: 10.2196/40875
Type of Publication: A2 Review article in a scientific journal
Field of Science: 113 Computer and information sciences
3122 Cancers
Copyright information: ©Anna-Mari Laitio, Guido Giunti, Raija Halonen. Originally published in JMIR Cancer (, 28.06.2023. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cancer, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.