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In August 2021 Barking, Havering, and Redbridge University Hospitals NHS Trust (BHRUT) were the first Trust in England to implement Varian’s Noona platform. This is a cloud hosted web/app-based platform designed to engage patients in their care with by providing an electronic platform to capture patient reported outcome measures (PROMs). Noona can provide streamlined clinical workflows and has integration capabilities with Varian’s ARIA electronic medical record system which used within BHRUTs radiotherapy and chemotherapy departments.

By monitoring acute radiotherapy toxicity using PROMs we hope to be able to intervene earlier in management patients side effects, avoid A&E attendances and hospital admissions. Additionally, we aim to improve the efficiency of clinics, highlight patients who can be reviewed by non-clinician trained health care professionals, streamline the handover of patient cases between the teams in the oncology specialty and avoid patients having to travel large distances to the hospital unnecessarily. We were also the first site in Europe and the UK to use the patient education module. This has meant that all our patient information leaflets can be send to patients electronically including links to further information from the Macmillan website (including languages other than English).  
Given the digital nature of the platform, we wished to assess its uptake after 1 year to identify which patient groups were or were not engaging with the system. 

All patients are introduced to Noona once a referral for Radiotherapy or SACT has been received.  Patients who opt-in to using Noona are sent an invite to access the system via an email or text message.

Using the analytics within Noona we analysed the number of patients who were using the app, their age range, cancer diagnosis, reason for use and satisfaction scores.

As of 19th October 2022, 1080 patients were invited to use the system 753 patients have actively used the system. The mean age of patients is 62.9 years old. Of note there are 161 patients between 70 and 79 years and 56 patients over the age of 80. The majority of patients using the system have a diagnosis of breast cancer (37.4%) followed by prostate (15.9%).    

When care teams have responded to patient’s questionnaire entries or symptom entry patients have rated the response as 4.56 out of 5.0. There have been 796 questions about a symptom entered by patients and 603 responses back to patients.  

We have sent 8210 automated messages to patients. 890 patient information articles (leaflets or URLs) have been sent to 415 patients.  

We have seen a good initial uptake to the system. Patients from an older age group were still active in use of the system in spite of fears they would be put off by a digital platform. The cancer diagnosis reflects the distribution of work in our department.  Satisfaction scores were high. Early positive experience means we will now further integrate Noona into more clinics/clinical scenarios.