Currently submitted to: JMIR Cancer
Date Submitted: Jan 31, 2026
Open Peer Review Period: Feb 10, 2026 - Apr 7, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Implementing UKONS-Informed Digital Symptom Triage With Episode-Based Review in Routine NHS Acute Oncology: A Service Evaluation
ABSTRACT
Background:
Patients receiving systemic anti-cancer therapy can deteriorate rapidly between appointments, yet acute oncology services often rely on reactive helplines with limited symptom visibility.
Objective:
To evaluate the feasibility, safety, and workflow integration of OncsCare, a digital symptom triage platform mapping patient-reported symptoms to UK Oncology Nursing Society (UKONS) acuity tiers with episode-based clinician review.
Methods:
This 10-week service evaluation (July–September 2025) implemented OncsCare within a UK tertiary acute oncology service. Patients completed daily symptom check-ins mapped to UKONS-informed green/amber/red tiers. Alerts were grouped into episode-level triage events using prespecified rules (48-hour window, symptom-domain continuity) to represent operational workload. Outcomes included engagement, alert distribution, escalation pathways, review timeliness, and safety signals via structured case-finding.
Results:
Thirty-two patients participated (none withdrew). Daily check-in completion rate was 91.7% (1444/1574 expected patient-days). From 362 amber/red alerts, 62 episodes were generated; 38.7% (24/62) were clinically actionable, resulting in telephone management (50%), acute care assessment (37.5%), emergency referral (8.3%), or admission (4.2%). Median review time for in-hours red alerts was 47 minutes. Predefined safety case-finding identified no intervention-attributable safety signals. Patients reported increased home reassurance (85%) and clinicians reported improved situational awareness without increased workload.
Conclusions:
UKONS-informed digital triage with episode-based review demonstrated feasibility and safety in routine acute oncology care. This operational model addresses alert fragmentation and supports multicentre evaluation. Clinical Trial: Not applicable
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