Helpful Resources

User’s Guide for Patient-Reported Outcomes in the Electronic Health Record was released by PCORI in May 2017. It provides a thoughtful evaluation of various approaches for integrating PROs into EHRs.

View the guide and slide presentations here>>

Integration in Clinical Settings

HealthMeasures can be integrated in clinical settings. When doing so, consider the following factors:

Identify Your Clinical Practice Needs

Use of patient-reported outcome measures (PROs) in clinical practice requires knowing your assessment goals, appropriate measures for those goals, which patients will complete measures, when patients will provide that information, and what you will do with the results. The International Society of Quality of Life Research (ISOQOL) published a User’s Guide for implementing PROs in clinical practice. Though not specific to HealthMeasures, the insights and suggestions apply to HealthMeasures.

Minimize Workflow Disruption

Collecting patient-reported outcome measures (PROs) in clinical settings requires time at multiple points in the clinic workflow. Ordering an assessment, completing an assessment, following-up on an incomplete assessment, reviewing results of an assessment, and addressing the results within a care delivery take time from healthcare providers, staff, and patients.

  • Assemble a multi-disciplinary team to identify a strategy that minimize disruptions in your setting
  • Utilize existing wait time for patients to complete an assessment
  • Create time for a patient to complete an assessment prior to interacting with his or her provider (e.g., schedule assessment appointment 20 minutes before visit)
  • Have a plan for patients that did not complete an assessment
  • Clearly define roles (e.g., who checks that assessment was completed, who answers technical questions, who cleans and charges devices used for data collection)
  • After implementation, communicate across all team members to address workflow issues

For more information on minimizing workflow disruptions, watch this 6 minute video.

 

Enable Multiple Data Capture Options

PROs are increasingly available within electronic health records. Using the EHR's patient portal can aid in collecting information from patients outside of the clinical setting. However, not all patients will complete an assessment through the EHR's patient portal for a variety of reasons.

  • Implement departmental or organizational efforts to encourage enrollment in the patient portal
  • Provide information about privacy
  • Ensure there are benefits to the patient for enrollment
  • Improve ease of registering and using the patient portal

Facilitate Use of Assessment Results in Clinical Care

If patients do not see their assessment results being used, they may not see a benefit to continuing to complete assessments.

  • Enable patients to track their scores over time
  • Graphs are often easier to interpret than tables of numbers
  • Select PRO measures that provide information that care providers and patients can use

Additional Factors to Consider

  • Number of assessments: Frequent assessments provide a more complete picture of a person’s health over time but can be burdensome for patients (to complete) and clinicians (to review).
  • Measures can be completed at a healthcare visit. This information is then available to the care provider. Alternately, measures can be completed between clinic visits. This allows more frequent assessment and less disruption to the workflow. However, it may not reflect how a person is doing on the day of a clinic visit and may require a process for providers to follow-up with people who are having problems or concerns.
  • Reporting of data: Data should be presented in an understandable format. This format may be different for the person who completed the assessment than for the care provider. This could involve terminology (e.g., “dyspnea” versus “trouble breathing”).

When to Assess

For information on when and how often to assess PROs, watch this 4 minute video.