Minding the Gaps Using Patient Reported Outcomes to Improve the Delivery of Care

Minding the Gaps Using Patient Reported Outcomes to Improve the Delivery of Care

For anyone who has traveled on the London Metro, “mind the gap” means watching your step between the subway car and therefore the platform once you enter and exit. Current measurements often specialize in observation from professionals and objective clinical data just like the range of motion, vital sign readings, and laboratory data. However, we will now incorporate another critically important metric: Patient-Reported Outcome Measures (PROMs).

What exactly are PROMs? they're data that a patient provides us with their condition, diagnosis, and/or treatment. Patient-reported conclusions are commonly accessed using validated patient surveys that consist of functional and quality of life measures. Why are patient-reported outcome measures important? Because they supply us with the foremost meaningful data which will help us improve health and well-being.

Success Factors

There is no standard playbook for collecting PROMs. Some organizations will gather data with a standard hardcopy survey while other providers will use sophisticated information systems. There are many free validated options available and therefore the National Institutes of Health has options available through their Patient-Reported Outcomes Measurement data system. But no matter the tool, the foremost important success factors to gathering information are engaged, patients and physicians.

Our patients have intimately involved in the planning of our processes. At the physician’s office, our patients can use a tablet, like an iPad, to enter their PROMs data. Or, the info is often collected via an emailed survey. Paper surveys also are available but most patients prefer a more modern method of collection.

Physician buy-in is additionally necessary for adoption. Clinicians should be indulged in choosing the survey instrument. When it involves specific survey questions, it’s best to succeed in a consensus among the physician group. Fortunately, there are many patient-reported questionnaire templates available. Specialty societies even have recommendations and specific tools that ought to be implemented. 

The information must be easily understood during a time-limited visit and cause action. To repeat the usually stated mantra, “it’s about the workflow”. HealthPartners clinicians have provided feedback on what information is vital to them and wherein their workflow it can add value. Additionally, quality resources assure data is reviewed from a population aspect of administrative leadership.

By using PROMs data, patients can understand their progress and the way it compares to the broader population’s outcomes for an equivalent procedure

Use Cases

As we start using the PROMs data, it’s important to watch how we’re ready to transform care. There are four major categories to think about the utilization of PROMs data.

• Enable the physician to personalize the care they provide: PROMs data, when arranged real-time to the physician, can help advise patient-centered care. an excellent example of this is often the PHQ-9 to watch therapy of patients treated for depression. Obtaining the PHQ-9 before the visit can help the treatment team monitor therapy and adjust treatment over time. This data is integrated into the visit documentation so it’s at the clinicians’ fingertips and may then be included in post-visit medical records.

• Use at the population level for continuous quality improvement: As you look out on a population, you'll use PROMs data to form practice-based changes and continually improve the care you provide. For instance, our orthopedic clinic utilized this data alongside physicians’ observations to vary how it treats patients following ankle fractures, improving their quality of life.

• Use for required state and federal government-related reporting: Quality transparency is remitted in some state and federal programs to drive improvement. In Minnesota, we have the Minnesota Community Measurement project. We now incorporate PROMs data during this measurement to reinforce the healthcare system in our state.

• Use to optimize patients’ care and improvement: Collecting and utilizing PROMs not only allows us to assess and track a patient’s functional, physical, and mental status, it also allows us to project a patient’s recovery following a particular procedure supported demographic variables like age, gender, BMI, and co-morbidities.

System Requirements

Gathering and reporting PROMs may be a sport. Busy care teams need simple processes to collect and present information to physicians or support team members. This has led to the subsequent high-level design framework.

• Engage the patient through multiple channels like email before the visit to get information. Tablets are often wont to administer surveys during visits but should have a fast interface to the EMR to be used by the care team at that point.

• Paper surveys should be available but limited to attenuate time-consuming data entry.

• Data should be in patients’ EMR and fit within the workflow. It should provide actionable data and will not require added documentation.

• Data should be incorporated into the organization reporting system data warehouse or other to facilitate analysis and quality improvement efforts.

• the info should be transparent to the patient including trends of patients with similar conditions.

Making this information readily available to patients is a simple thanks to supporting them in their care journey. By using PROMs data, patients can understand their progress and the way it compares to the broader population’s outcomes for an equivalent procedure.

What’s within the Future? the worth Proposition for Proms

Now that we are “minding the gap” of patient-reported outcomes, we will better measure the worth of care we’re delivering.

Eventually, transparent PROMs data could drive patients to organizations where they perceive their care is going to be of the very best quality and greatest value. PROMs data also will be utilized in combination with financial data, allowing patients to match the value of care with outcomes.

Ultimately, evaluating PROMs will help us manage chronic conditions and drive quality improvement opportunities, also as enhance regulatory reporting, reimbursement, cost comparisons and competition among health systems.


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