From trigger to consultation: feasibility of the patient-reported ONCOlogical ROUTinE Screening (ONCO-ROUTES) across a comprehensive cancer center network

Abstract

Abstract Purpose The German oncological certification program requires multi-domain routine screening for supportive care needs. However, most centers operate separate single-domain instruments, and published implementations rarely track how screening results are acted upon. Therefore, we piloted the ONCOlogical ROUTinE Screening (ONCO-ROUTES), a 47-item patient-reported multi-domain screening, and followed each trigger through to the documented consultation. Methods We conducted a prospective multicenter feasibility study (April–June 2026) at four hospitals of a comprehensive cancer center network. Three hospitals used a paper-based workflow (n = 345), one a fully digital workflow (n = 169). Realization of screening results was defined as a documented consultation within 30 days, captured from the hospital information system or consultation checkboxes. Results Of 570 distributed screenings, 514 were returned (90.2%; paper-based 92.7–97.8%, digital 79.3%). Median digital completion time was 12 minutes (n = 175); staff effort was 1–5 minutes per screening. The screenings yielded 963 trigger-positive findings (1.9 per screening); realization ranged from 83–89% (inpatient maximum) to 4–23% (outpatient medical care center, MVZ). Realization depended on direct access: in outpatient (MVZ) units without in-house consultation authority, 88–98% of trigger-positive findings were addressed (performed or recommended). Time to consultation was structure-dependent (median 1 vs. 8.5 days); consultation realization was higher in certification-relevant primary cases (45% vs. 27%, p < 0.001). Conclusion A single multi-domain patient-reported screening is feasible in routine care across heterogeneous hospital settings. Translation of identified needs into consultations depends on organizational structures and sectoral boundaries rather than the screening instrument.