Palliative care (PC) referrals for patients with advanced cancers often occur late despite evidence that early, concurrent PC improves quality of life, symptom management, and patient satisfaction. Dartmouth Cancer Center’s electronic symptom management (eSyM) program collects electronic patient-reported outcomes (ePROs), and the PRO-CONNECT Study is evaluating whether these data can prompt more timely PC referrals. To refine an ePRO-triggered referral workflow before pilot testing, semi-structured focus groups were conducted from May to August 2025 with 53 clinicians representing six oncology and supportive-care teams. Participants discussed feasibility, workflow integration, communication needs, and team coordination related to incorporating monthly ePRO alerts into practice.
Clinicians supported the use of ePRO screening to standardize referral practices but emphasized the need to keep workflows simple, avoid automatic referrals, and ensure oncologists review alerts before initiating PC referrals. Concerns included limited palliative care capacity, current 3–4-week wait times, and uncertainty regarding team roles in reviewing alerts, contacting patients, and coordinating care. Clinicians also recommended embedding social work into triage processes and reframing palliative care as “supportive care” to reduce stigma and facilitate patient engagement. These insights informed a streamlined, clinician-guided referral pathway aligned with real-world clinical operations. Pilot testing will occur in Fall 2025, with future work incorporating patient and caregiver perspectives to improve communication strategies and enhance workflow acceptability.