Remote Symptom Assessment in Ambulatory Palliative Care: User-Centered Development of an mHealth App.

Abstract

Ambulatory palliative care (PC) focuses on managing complex symptoms, yet assessment relies on recall during infrequent visits to manage daily fluctuating symptoms. We aimed to design a PC-anchored remote symptom assessment (RSA) tool with patients and clinicians. We used user-centered, Agile design to develop and iteratively refine EMA-PAL, a web-based RSA prototype. Patients and clinicians (<i>N</i> = 14) from an ambulatory PC clinic participated in staged prototype development and testing through focus groups and interviews. EMA-PAL features patient- and provider-facing interfaces that visualize daily Edmonton Symptom Assessment System (ESAS) scores, highlight severe symptoms, and support shared review during visits. Participants endorsed EMA-PAL's potential to enhance communication and workflow efficiency and identified priorities for future development (medication tracking and workflow integration). This exploratory pilot suggests that PC-anchored RSA tools such as EMA-PAL may help address gaps in symptom assessment and timelier and patient-centered symptom management in ambulatory PC.