Table 2.

Themes from provider work group sessions on app development

Theme	Example
Comprehensive pain diary	“If you’re going to do the pain score, tracking, well, when the pain was this—what did I do for it? Or what did I take?”
Medication reminders and use monitoring	“If you’re working with a patient, you can say, well, how often do you feel you need a reminder? And then do you have the flexibility of every day, every other day?”
Provider alert messaging	“If it [patient pain level] meets a certain threshold, then you know, then there’s a prompt to send out an alert.”
Improved triage and communication	“The two things I hear from people all the time is: it’s hard for them to describe things, and they don’t know what to do when to call, when to panic. And if you address those two—you say, okay, if your pain gets to a five, I need you to pick up the phone—then they relax.” “Because then when they call, you’re like, oh, let me have a look [at patient generated symptom reports on the app] and see what you’ve done. Ok, that didn’t work. Ok, that worked. Oh, I can try this.” “If we’re going to change somebody’s pain medication, it would be great to know what the last four or five days looked like.”
Addressing barriers to care	“Resources that are kind of all scattered across the internet, consolidating those resources in one place and have those be resources that are vetted.” “We can broaden the application so that not only do we manage symptoms that are disease related, but also any impediments to the delivery of care. That’s really important because I mean, to get people to comply with what you propose...” “We probably should include some kind of either logistical or financial scale, because I think sometimes those issues contribute to compliance and symptom management, but patients are not prompted and won’t volunteer that.”
Encouraging and supporting patients through difficulty	“I think when I first get someone who’s newly metastatic, it’s a whole shift in psyche ... And when they progress on their therapy, even though they’ve been through it once they’re like, oh crap, I’m back at the beginning again. And so how do we get them moving through that next set of events and getting that [next] therapy started. Because they’re sort of on this constant roller coaster, emotional and physical and psychological. Living scan to scan.”
Vetted educational material for patients	“We’re always telling patients, ‘don’t look at that—look at this.’”
Partnering with caregivers	“By the time they’re at that point [of serious symptoms], a lot of times the caregiver is involved. And I think the caregivers really calm down if you give them stuff to work from, like a document. I think that’s really important because most of them feel so inadequate.”