PROMs are different from regular healthcare measures because patients report them directly. They focus on care results instead of just the care steps. For example, hospitals used to focus on things like readmissions and clinical signs such as blood pressure or lab tests. PROMs check if patients feel better, can function well, or keep their quality of life after treatment. This fits with care models that value patient results more.
Examples of PROMs include the SF-36 survey, which checks general health, and specific tools like the Oswestry Disability Index for back pain patients. Some hospitals, like Dartmouth-Hitchcock Medical Center and the University of Pittsburgh Medical Center, use these surveys regularly. Sometimes patients fill them out using tablets or online.
One big problem is how PROMs fit into doctors’ daily work. Many doctors worry that collecting PROM data takes extra time. This can slow down patient visits and add to their already busy schedules. Doctors also get too much information sometimes, which is hard to sort or use.
Doctors may not be familiar with how to use PROM data. They may not have training, which makes them less eager to start using PROMs. Liam Jackman and Rakhshan Kamran pointed out that getting doctors interested is important but difficult because of extra tasks and paperwork.
Many clinics still use paper forms for PROMs. This method is slow, can cause mistakes, and needs someone to type the information into electronic health records (EHRs). When data is entered late or wrong, it is less helpful for real-time decisions.
Manual entry also makes it hard to track patient information over time. Without good connections between systems, PROMs stay a side task instead of being a main part of care.
Electronic PROMs (ePROMs) make collecting data easier. But not all patients can use digital tools well. Older people, low-income groups, and some other communities may not have devices or internet. Some may find online surveys hard to understand.
This “digital divide” means some patients might miss out on PROM benefits. Rakhshan Kamran said that it is important to have clear language and easy-to-use systems to avoid making these gaps bigger.
Healthcare systems use many different IT platforms that do not always work well together. Data is often stuck in separate places. This makes it hard to share PROM data between departments or when patients move between care providers.
Patients may see many healthcare workers, so their PROM data should link correctly at all steps. However, the lack of common formats and sharing rules is a problem. Standards like HL7 FHIR and SNOMED CT help but are not used everywhere in the US.
Handling PROM data needs careful attention to laws like HIPAA. Sometimes other rules like GDPR matter, especially if data crosses borders. Keeping patient data private and safe can make PROM use harder. This needs good IT systems and clear rules.
Switching from paper to electronic PROMs makes things faster and easier. Patients can fill out surveys at home or anywhere using tablets, phones, or computers. Data is captured in real time and links automatically to health records, which cuts down mistakes and speeds up use.
Systems should be built to help patients with different digital skills. They should offer many ways to access surveys.
CAT uses smart computer programs to change questions based on how patients answer. This shortens the survey but keeps it accurate. It makes surveys easier and faster for patients to finish, especially in busy clinics.
It is important to make PROMs part of usual care steps. For example, patients can fill surveys before visits or during registration. This helps avoid slowing down the clinic.
Doctors use PROM data more when it is shown clearly and fits into decision tools. Training staff about PROM benefits and how to use the data helps get more use.
Spending on systems that let PROM data move smoothly between EHRs, specialists, and patient portals helps improve care. PROM data can travel with patients as they see different providers.
Researchers like You Chen say AI can help break down data barriers and make sharing easier.
Healthcare groups should build PROM tools that work for all patients. This means thinking about access and language skills. Using phone surveys or in-person help makes sure no one is left out.
Staff training in cultural understanding and health literacy supports diverse patient needs. Rakhshan Kamran noted that inclusive data collection helps reduce care gaps.
Keeping PROM data safe builds patient trust. Organizations should use encryption, login controls, and policies that follow rules like HIPAA.
Telling patients clearly how their data is used and protected helps them feel comfortable.
AI can help collect and understand patient data automatically. For example, natural language processing (NLP) can read patient comments and find health information that surveys may miss.
Predictive tools can spot trends and help doctors see if a patient might get worse or respond well to treatment. This allows for care to be planned earlier and to fit each patient.
AI can change PROM data from different places into a common format. This helps share information between healthcare platforms better.
By breaking down data silos, AI makes sure PROMs help guide care across many visits and providers.
AI can automate tasks like sending reminders, scoring surveys, and pointing out concerns for doctors.
This lowers extra work for clinical staff so they can spend more time on patient care.
AI can adjust PROM survey designs to patient needs. Systems may change question difficulty, offer multiple languages, or provide chat help for those who need it.
Better designs encourage patients to finish surveys and improve data quality.
Investment in Infrastructure: Moving to digital PROM systems and linking them with EHRs costs money for software, devices, and training. But these investments can make operations smoother and meet value-based care demands.
Training and Change Management: Leaders should create programs to teach staff about PROM benefits and workflows. Good leadership helps PROMs become part of clinic culture.
Provider Engagement: IT teams should pick tools that show PROM data in clear ways. Decision support systems that include PROM results help doctors accept this approach.
Addressing Patient Diversity: US clinics serve many different people. Providing multiple ways to complete PROMs and supporting health literacy helps give fair care.
Data Governance and Compliance: Clinics must handle PROM data following HIPAA. Strong cybersecurity and being clear with patients about data use is important.
Collaboration with Vendors: Choosing tech partners that focus on healthcare PROM systems and use AI and automation features can make implementation easier.
By solving these problems and using new technology, healthcare groups in the US can better add PROMs into their work. This supports care focused on patients, improves results, and helps meet payment models based on value. Medical practice leaders, owners, and IT staff must work together to manage challenges and use solutions that fit their clinics and patients.
PROMs are tools used to assess the health status and quality of life from the patient’s perspective, focusing on outcomes such as general health, activity levels, mood, fatigue, and pain.
Unlike process measures that assess provider productivity and patient experience measures that focus on care delivery, PROMs evaluate whether provided services actually improve patients’ health and well-being.
PROMs face challenges such as workflow disruptions for clinicians, lack of reimbursement for time spent on outcome surveys, and difficulties linking outcomes to specific treatments.
PROMs are expected to become central to assessing performance and effectiveness of treatments, contributing to value-based payment approaches by ensuring that patient perspectives are integral to care evaluation.
The SF-36 and Oswestry Disability Index are examples of PROMs used at medical centers like Dartmouth-Hitchcock and the University of Pittsburgh to assess patient health status and functional outcomes.
PROMIS aims to create precise, validated measures across various domains of well-being, reduce the number of questions for feasibility, and support computerized-adaptive testing to tailor questions to patient responses.
ACOs can leverage PROMs to improve care coordination, measure patient outcomes, and evaluate the effectiveness of comprehensive treatment approaches across various services related to a patient’s care.
Future trends may include widespread integration of PROMs in electronic health records, easier patient access through digital tools, and the aggregation of data at organizational and national levels for benchmarking.
Factors such as the ease of data collection for patients, clinician training for outcome interpretation, and the need for standardized data across treatment transitions influence PROM implementation.
Engaging patients in the development and validation of PROMs ensures the measures are relevant and valid, reflecting their experiences and preferences in health assessments.
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