A statewide initiative in New South Wales has described how structured change-management strategies can support the large-scale implementation of digital patient-reported outcomes in oncology care.
In a case study published in JBI Evidence Implementation, Mazariego and colleagues outlined the rollout of an electronic patient-reported measures (ePRM) system across cancer services in NSW. The platform captures electronic patient-reported outcome measures (ePROMs), enabling patients to report symptoms, treatment effects, and quality-of-life concerns directly to their care teams.
Electronic patient-reported outcomes have a robust evidence base showing that when routinely collected and acted upon in clinical settings,s they can enhance patient-centred care and support clinical decision-making. However, integrating these tools into routine oncology workflows has often proved challenging because of workflow disruption, time constraints, ts and clinician resistance.
CLINICAL SUMMARY
What was examined
A case study evaluated the statewide implementation of an electronic patient-reported measures (ePRM) system designed to capture electronic patient-reported outcome measures (ePROMs) and integrate them into routine oncology care across New South Wales.
Key findings
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A structured change-management strategy based on the ADKAR framework supportthe ed adoption of the digital system across cancer services.
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Implementation strategies included stakeholder engagement, clinician training, workflow adaptation, and ongoing performance monitoring.
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Implementation barriers such as clinician workload concerns and perceived duplication of documentation were addressed using an implementation science framework,s including CFIR and ERIC.
Clinical implications
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Successful integration of digital patient-reported outcome systems requires structured implementation and change-management strategies alongside technology deployment.
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ePROM platforms may support symptom monitoring, patient-centred ca, re and data-informed clinical decision-making in oncology.
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The implementation framework may provide a model for other jurisdictions seeking to scale digital health tools across cancer services.
To address these barriers, the NSW implementation adopted a structured change-management approach guided by the ADKAR framework, which focuses on building awareness, desire, knowledge, ability, and reinforcement among stakeholders.
The study used a retrospective case-study methodology to document the statewide implementation process. Change-management strategies included targeted stakeholder engagement to build clinician support, role-specific training programs, site-based troubleshooting to adapt local workflows, and ongoing performance monitoring to reinforce sustained adoption.
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Implementation barriers such as perceived duplication of documentation and concerns about increased workload were analysed using the Consolidated Framework for Implementation Research (CFIR), with mitigation strategies mapped to the Expert Recommendations for Implementing Change (ERIC) taxonomy.
The initiative ultimately produced a practical implementation checklist intended to support organisations undertaking similar digital health transformations.
The authors conclude that successful scaling of digital health tools requires structured change-management approaches in addition to technology deployment. By combining proactive planning, iterative system design, and embedded support, digital innovations such as ePROM platforms can be integrated into routine oncology practice at scale.
Paper: Mazariego, C., et al. Driving statewide digital transformation in oncology care: a change management case study using ADKAR methodology for the implementation of patient-reported outcomes in cancer clinical care. JBI Evidence Implementation:10.1097/XEB.0000000000000559, February 17, 2026. | DOI: 10.1097/XEB.0000000000000559 Access online here.
