Patient-Reported Outcome Measures (PROMs) are questionnaires that patients fill out, often before or during doctor visits. These forms ask about things like pain, how well they can move, their mental health, and how happy they are with their care. PROMs are used in hand surgery to see how treatments work for conditions like carpal tunnel syndrome, trigger finger, osteoarthritis, and other hand problems.
Even though many healthcare areas use PROMs, hand surgery clinics still have some way to go to use them well. Researchers say there is not yet an agreed way to collect and explain PROM scores during visits.
A group of nine hand surgeons in the U.S. studied twelve possible rules for using PROMs regularly. They looked at how important, easy, and useful these rules were. While they agreed PROMs matter, they could not decide on any set of rules because there isn’t enough proof on the best way to use PROMs for each patient during visits.
Because of this, many clinics are not sure how to include PROMs every day. This means PROMs may not be used to their full ability to help doctors give care that fits each patient.
Shared decision-making is when patients and doctors work together to choose treatments. They use medical facts and what the patient prefers. PROMs are important here because they show how the patient feels and what they expect. This helps doctors understand the patient better.
A big study looked at 25 hand surgery clinics in the U.S. It compared patients whose doctors used PROMs during visits to those who did not. There were 636 patients in the PROM group and 212 in the other group.
The study found patients with PROMs had much better shared decision-making. They also had better experiences, expected better treatments, and trusted their care more. This means talking about PROM scores during visits can make the visit better and patients happier. It also fits with healthcare approaches that focus on good results at fair costs.
Even though PROMs have clear benefits, there are some problems with using them regularly in hand surgery.
One problem is that many PROM questionnaires are hard to read. A study checked 26 PROMs often used in sports and bone medicine. Most were written at a level too hard for many patients. Experts say PROMs should be easy enough to read at about a sixth-grade level. But most were at eighth or ninth-grade levels, making it hard for some patients to understand.
Only four PROMs met the easy-reading rules, including the Numeric Pain Rating Scale. Reading level is important because if patients don’t understand the questions, their answers might not be correct. This makes it harder for doctors to use the information well.
Another issue is there are no standard rules for when and how to collect and share PROM data during visits. Clinics do this in many ways. Some use paper, others use online forms. Some staff may not know how to understand PROM data. Without clear steps, PROMs can become more work for clinics instead of helping care.
Doctors also need time to use PROMs in busy clinics. Doing this along with caring for patients and paperwork can be tough without good technology.
Healthcare workers and managers in the U.S. are using technology to make work easier and improve patient care. Artificial intelligence (AI) and automation can help solve problems with PROMs.
AI can send out PROM forms, collect answers, and score them without clinic staff doing it by hand. Patients can fill PROMs online, on tablets in the waiting room, or at home before visits. AI can quickly turn answers into reports that are easy to read.
For example, some companies use AI to handle phone calls and reminders. These tools can remind patients to fill PROMs, help them if they have questions, and alert doctors if scores show problems.
AI can also mix PROM data with other medical data in patient records. This helps tools that support doctors in making choices by showing all the important information together. When doctors have easy and clear PROM data, shared decision-making gets better.
Because reading PROMs can be hard for some patients, AI tools can change the language to match the patient’s reading skills. AI can also read questions aloud or explain them during completion. This helps patients understand better and give more accurate answers.
AI can also help with scheduling, checking in patients, sending reminders, and sorting urgent PROM answers. This reduces the work for staff and lowers mistakes. It helps clinics spend more time with patients.
IT managers can use AI tools to connect PROM systems, patient record systems, and communication tools together. This makes the whole process work smoothly with less human work.
Healthcare payment in the U.S. is moving toward value-based care. This means showing good results that are worth the cost. PROMs help by showing clear proof about how patients improve and how happy they are.
In hand surgery, tracking PROMs over time shows how patients recover after surgeries like carpal tunnel release. Good PROM collection helps with quality checks, doctor reviews, and reports needed by insurance.
But PROMs only work well if collection is steady, data is accurate, and doctors use the feedback in decisions. Without clear steps and technology help, these goals are hard to reach, which limits PROMs’ value for care.
Train Clinical Staff: Teach doctors and staff why PROMs matter and how to use them in visits to help make decisions with patients.
Implement Readability Standards: Choose PROM questionnaires that are easy to read at about a sixth-grade level to help patients understand and give good answers.
Leverage Technology: Use AI and automation tools to make PROM sending, scoring, reporting, and patient record connection easier.
Prioritize Patient Engagement: Use automated reminders and different ways to contact patients so they complete PROMs before visits.
Develop Protocols: Make clear steps on when and how to collect, check, and use PROMs during care, based on evidence and expert advice.
Focusing on these points helps hand surgery clinics use PROMs better to improve care, meet healthcare rules, and run smoothly.
PROMs are useful tools in hand surgery clinics in the United States, especially when used to help make treatment choices and supported by technology. There are challenges in using PROMs, but AI and automation can help solve problems like data collection, patient understanding, and doctor use. Healthcare managers and IT leaders can benefit by using these tools to improve patient care, treatment trust, and fit value-based healthcare goals.
PROMs are questionnaires or surveys completed by patients that provide information on their health status, quality of life, and the effectiveness of treatments from their perspective.
PROMs are essential as they capture the patient’s perspective, helping healthcare providers understand treatment effectiveness and improve patient-centered care.
The study aimed to develop process guidelines for the routine collection and communication of individualized PROMs at the point of care in hand surgery.
A consortium of nine fellowship-trained hand surgeons evaluated the importance, feasibility, usability, and scientific acceptability of twelve candidate process guidelines using a modified Delphi method.
The expert panel did not reach a consensus on the validity of any of the twelve candidate process guidelines for collecting and communicating PROMs.
The domains of importance and feasibility received higher median scores compared to usability and evidence, indicating a greater appreciation for their potential.
The lack of consensus suggests an urgent need for clearer guidelines on how and when to collect PROMs to enhance individual patient care.
PROM scores can be utilized as communication tools or to inform management decisions, thereby tailoring treatment options to individual patient needs.
Challenges include insufficient evidence supporting the use of PROMs, variability in practice standards, and potential limitations in clinician training and system integration.
PROMs guide outcome assessments that reflect the patient perspective, informing shared decision-making and improving overall patient satisfaction and treatment outcomes.
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