Real-time symptom reporting helps Sofia stay in the game during cancer treatment

Sofia is tough—on and off the field. The 13-year-old is a forward on her soccer team, likes to play volleyball and is the oldest of three energetic younger siblings.

So when a lump in Sofia’s neck led to a diagnosis of Hodgkin lymphoma in October 2025, her care team focused not only on treating her cancer, but helping her stay active. That means, in part, responding quickly when her treatment makes her feel sick or causes an adverse side effect.

A symptom reporting and management tool called SSPedi, developed in-house at The Hospital for Sick Children (SickKids) by Drs. Lillian Sung and Lee Dupuis, helps patients report symptoms in real time from the comfort of their home.

“The burden of symptoms that children with cancer face is troublesome,” says Dr. Adam Yan, Oncologist and Associate Chief Medical Information Officer (Academic Pediatrics) at SickKids. “We don’t see patients in clinic every day, so we don’t ask them how they’re feeling every day. If we don’t ask, we don’t know how to help with any new or evolving side effects.”

SSPedi prompts a patient or parent several times a week to complete a brief questionnaire online covering physical symptoms, emotional well-being and overall health.

Recently Dr. Yan and the Remote Care Management team, led by Dr. Daniel Rosenfield, Bren Cardiff and Ashley Graham, worked together to integrate SSPedi into MyChart, allowing both patients and care teams to report and respond to any emerging side effects, linking every response and action back to the electronic health record.

Sofia has felt that impact firsthand.

“I was really nauseous one day, so I put it into the app,” she says. “Twenty minutes later they called us and said we could go to the pharmacy and pick up something to help. I like it because it feels like there’s always somebody there.”

Her dad Matt agrees. “As a parent, I’ve found it very helpful. It’s set up on my phone so it’s easy to access, and if there is something that comes up, it goes directly to someone who can help.”

Beyond symptom reporting, SSPedi also offers tailored tip sheets and guidance for managing symptoms at home.

Now more than halfway through treatment, Sofia says that although she doesn’t feel great the first few days after receiving chemotherapy, she’s happy she can keep going to school, playing soccer and connecting with friends.

Integrating the right technology to provide individualized care

SickKids is the first hospital in the world to integrate SSPedi into Epic, a milestone that reflects the organization's commitment to embedding digital tools directly into clinical workflows. The work was recently published in JCO Clinical Cancer Informatics.

“The data is unequivocal that any friction you introduce into the digital space, the less likely any of those interventions will be adopted,” says Dr. Rosenfield. “Having all the information in one place improves its use, and most importantly it’s better for patient safety and continuity through their care.”

It’s a meaningful shift that embodies Precision Child Health, a movement that relies on data-driven insight to individualize care to each child’s specific needs.

SSPedi was recently selected for inclusion in Epic Foundations, a cluster of tools that Epic provides to every hospital using the Epic electronic health record, meaning any children’s hospital that uses Epic can adopt it into their own workflows. The selection signals its potential to reduce burden on patients and families and strengthen team-based management and follow-up.

“We’ve built the tool and implemented it,” adds Rosenfield. “Now we’re sharing to better paediatric care for children with cancer around the world.”