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Patient Reported Outcome Measures

NOMINATED TOPIC | February 4, 2019
Describe your topic.
What is the issue or question? What evidence exists to demonstrate that patient reported outcome measures (PROMs) provide actionable data for clinicians to help improve care outcomes? • Which PROMs are associated with improved care outcomes? For which types of therapy, which types of diseases, and in which settings? • How have these those PROMs been integrated into care processes? • What interventions can facilitate incorporation of PROMs into patient encounters? Identify the population of interest, including details such as age range, gender, coexisting diagnoses, and reasons for therapy. • Adult patients with complex chronic conditions (i.e., high-risk/high-cost patients) receiving very specific care interventions (e.g., joint replacement surgery) • Outpatient setting (although potentially initiated in the hospital prior to discharge) Identify the interventions (treatments, tests, or strategies) that you want to know more about, and what are the appropriate comparisons. • Implementation of PROMs for complex chronic conditions and associated improvements in clinical outcomes (e.g., Patient Reported Outcomes Measurement Information System [PROMIS]) Identify the important outcomes (health related benefits and harms) in which you are interested, such as improvements in symptoms or problems with diagnosis. • Patient Engagement • Quality: Patient functionality and quality of life, for example: pain free days, days at work, distress scales, fatigue • Value/Costs: Service utilization (e.g., ED visits, use of drugs and other healthcare services, preventable readmissions)
Describe why this topic is important.
There are several reasons why this topic is important to health systems: 1. In an ongoing effort to improve the value of health care, health systems are increasingly receiving mandates from the federal government (e.g., The Medicare Health Outcomes Survey) to collect and report PROMs. Health systems would like to have evidence about whether or not these mandates – and related – measures are effective at improving clinical outcomes – in other words, to be able to “make the clinical case” to leaders and clinicians about the importance of the mandate and the resources needed to support it. 2. To ensure that health systems use resources wisely and effectively, they would also like evidence on the resources needed to implement interventions to improve their PROMs outcomes/ratings, as well as strategies for incorporating PROMS as part of routine practice. 3. Health systems must prioritize the interactions/interventions that they employ with patients, and, would like to know the relative value of PROMS compared to other measures of quality (such as outreach to ensure completed testing, screening, etc.).
Tell us why you are suggesting this topic.
Incorporating PROMs into clinical care practice (v. in RCT and clinical research) is relatively recent. As organizations seek to find ways to improve patient care and outcomes, while providing patient-centered care, PROMs offer a unique opportunity to effectively do both. However, because this is a relatively new topic, organizations lack clear direction for how to incorporate PROMs, or which PROMs are most effective. Clarifying the current state of the evidence around this topic will help LHSs prioritize what and how to implement PROMs in practice. This topic is being suggested to support decision making around PROMs in clinical care and provide evidence for successfully incorporating clinically meaningful PROMs to support clinical outcomes.
Target Date.
Describe what you are doing currently and what you are hoping will change because of a new evidence report.
How will you or your group use the information from a new evidence report?
Health systems will use evidence about the effectiveness of PROMs to make a stronger clinical case for (or against) mandates and interventions related to PROMs. Further evidence supporting implementation would be helpful to build the case internally for their use as LHSs seek to implement regulatory requirements for use. As one LHS panel member shared, “If you find evidence that something is effective, you can make a stronger clinical case that it’s easier to do and important to do.”
How would you or your group plan to disseminate information from the report? Who would you plan to disseminate it to?
Many of the organizations represented on the LHS Panel are members of the High Value Healthcare Collaborative (HVHC) and could potentially distribute this report to other HVHC members. The HVHC is a provider learning network committed to improving healthcare value through data and collaboration. To accomplish this, the HVHC measures, innovates, tests, and continuously improves value-based care. Rapidly disseminate and facilitate adoption of proven high value care models across HVHC members and beyond. Within the LHSs represented on the panel, findings from the evidence reports would be disseminated internally through communication and education with appropriate stakeholders to support decision-making around implementation of PROMs within the context of the organization. Additionally, several of the LHS panel members are members of the Health Care Systems Research Network (HCSRN), an innovative consortium of research centers based on community-based health delivery systems. Thus, the LHS panel members could potentially disseminate this report to other HCSRN members.
Do you know of organizations that could use an evidence report to change clinical practice? Are you a part of, or have you been in contact with, any organizations that might implement the research findings of an evidence report?
Information About You: (optional)
Provide a description of your role or perspective.
Chief Quality Officer
If you are you making a suggestion on behalf of an organization, please state the name of the organization.
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Page last reviewed March 2019
Page originally created February 2019

Internet Citation: Patient Reported Outcome Measures. Content last reviewed March 2019. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.

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