Patient-facing cancer mobile apps that enable patient reported outcome data to be collected: A systematic review of content, functionality, quality, and ability to integrate with electronic health records

Purpose: Enabling cancer patients to self-manage symptoms through mobile applications can result in more informed, autonomous patients who are partners in their care, consequently reducing the burden on health services. Electronic patient reported outcomes completed before a clinical review can increase the frequency and quality of holistic assessments, while integration into electronic health records can maximise clinical utility. The ability of apps to integrate with electronic health records is key to providing a real-time interface between patient reports and healthcare response. This review identifies patient-facing cancer apps which can record patient reported outcomes, and explores their purpose, functionality, quality, and ability to integrate with electronic health records. Methods: A systematic app review and content synthesis was conducted on patient-facing cancer apps available in the United Kingdom. Where applicable, the review aligned with the Preferred Reporting Items for Systematic Reviews and meta-Analysis. Two validated scales assessed functionality and quality: The IMS Institute for Healthcare Informatics functionality score and the Mobile App Rating Scale. Flesch-Kincaid metrics explored readability. Results: Apple App and Google Play stores identified 405 apps, of which 12 met the eligibility criteria. All were free to download, 1 (8%) had in-app purchases/subscriptions. Nine (75%) were affiliated with a professional health body/charity. Six (50%) analysed inputted data and provided medical advice based on answers. The average Flesch Reading Ease score was 42.7 out of 100. The apps had an average of 7.3 functions each and a mean MARS score of 4/5. None integrated with electronic health records. Conclusion: While many cancer apps exist, few enable patient reported outcomes to be recorded and shared with clinicians in real-time. Further research is warranted to explore the feasibility of integrating with electronic health records, as this function can improve patient experience and outcomes, and increase efficiency of hospital resources through more proactive care.