Symptom Tracking for Patient-Reported Outcomes in Cancer: User-Centered Design of the AthenaCompanion Web Application.

Epidemiological and biological risks refer to situations with a high probability of leading to major health crises, and the development of “one health” strategies represents a key preventive approach, particularly against emerging or re-emerging zoonoses [,]. The Caribbean is considered a high-risk area because of its tropical climate, its proximity to the primary forests and wildlife of South America, its role as a major exchange hub in the region, and its insular isolation []. Martinique, a French overseas territory in the Lesser Antilles particularly affected by arboviral diseases, has had to regularly adapt its health care system to recurrent and emerging epidemics [,]. Since the 2000s, it has witnessed significant and frequent dengue epidemics (2001, 2005, 2007, 2010, 2013, and 2020), as well as new arboviral diseases such as chikungunya in 2014 and Zika in 2016. In addition, frequent health alerts related to transmissible infectious diseases have required public health responses, including severe acute respiratory syndrome in 2003, H1N1 influenza in 2009, Ebola in 2014, SARS-CoV-2 in 2019, mpox (monkeypox) in 2022, and Oropouche virus in 2024 []. Specific characteristics of such epidemics in exceptional health situations include a distinctive pattern of patient influx characterized by exponential transmission over an extended period [], the need for infectious disease research to identify novel pathogens and implement collective protection measures aimed at limiting the number of cases [], a possible weakening of the health care system due to health care workers falling ill and experiencing stress [,], and, finally, clear communication to ensure that the population maintains adaptive behaviors and an acceptable level of anxiety, particularly when the infectious agent is unknown [,]. The most recent major epidemic in the French West Indies exhibiting these characteristics was the COVID-19 pandemic. This epidemic triggered a global social and health crisis, profoundly disrupting health care systems []. Caribbean territories were particularly affected, initially marked by distrust of the health care system and significant anxiety, followed by a surge in cases and high mortality []. In response to the first cases of COVID-19 in Martinique in March 2020, adapting the organization of the health care system became essential. The emergency medical service (EMS) call center in Martinique established a teleconsultation platform within the first week after the first diagnosed case to monitor outpatients with suspected SARS-CoV-2 infection. This initiative aimed to prevent emergency services and hospital departments from being overwhelmed by nonessential consultations, while ensuring continuous remote medical monitoring to address patient needs and concerns regarding this novel and poorly understood epidemic and minimizing the risk of viral transmission. The follow-up unit was located within the EMS at the University Hospital of Martinique and was supervised by an EMS physician. It operated daily during daytime hours, from March 10 to May 31, 2020, covering the first COVID-19 wave. The unit was staffed by 4 residents and 2 to 3 physicians from the hospital’s outpatient consultation services, whose regular activities had been temporarily suspended. A dedicated app was developed, incorporating a standardized daily questionnaire used by all staff for individual follow-up. During daily staff meetings, infectious disease specialists reviewed patients whose conditions had worsened and arranged hospital admission when necessary.