In 2017, the Patient-Centered Outcomes Research Institute (PCORI) released a User’s Guide for Patient-Reported Outcomes in the Electronic Health Record.
A 2018 NEJM Catalyst article outlines advantages, challenges, and costs for three common methods of integrating PRO measures into the Electronic Health Record: custom-built solutions, EHR vendor solutions, and independent commercial products.
Selecting a Data Collection Tool
Multiple data collection tools can be used for HealthMeasures. Know your requirements to select the tool best suited for your work.
TIP: If you are using NIH Toolbox® measures of cognitive, motor, and sensory function, use the NIH Toolbox iPad App. It is the only tool that includes all NIH Toolbox measures, automatic scoring, and user support.
- Use the Search & View Measures to identify what tools currently include all of the measures of interest.
- Computer adaptive tests (CATs) and NIH Toolbox Cognition, Motor, and Sensation measures require a computer, iPad, or tablet for administration.
- Try the PROMIS® CAT Demo>>
- Read about the data collection tools that include HealthMeasures in their measure library. Learn more>>
- If you have a data collection platform you use and like now, consider adding HealthMeasures self- or proxy-report short forms. You can utilize the HealthMeasures Scoring Service for free to produce scores when it is time for data analysis.
- If you want to use CATs, consider integrating the Assessment CenterSM API with your system. Learn more>>
Commonly Required Features
- The NIH Toolbox and PROMIS iPad apps enable offline data collection on an iPad.
- The REDCap mobile app includes selected HealthMeasures for offline data collection on a mobile device. As of 2017, a user would need to use the HealthMeasures Scoring Service to calculate scores.
- Many online data collection tools include HealthMeasures including CATs, in their measure libraries. This enables online data capture on a range of devices in a variety of settings. Online tools:
- Assessment Center, Epic, API users (e.g., REDCap, OBERD)
- Some data collection tools enable administration of non-English measures. These include:
- REDCap, Assessment CenterSM, NIH Toolbox iPad app
- Some data collection tools are supported by grants and institutions, not the individual researcher or clinician. If you do not have a budget for data collection, identify what options are provided by your organization. Examples of tools with costs covered by grants, institutions, or advertisers:
- REDCap, Epic, OBERD (free for some researchers), web-based survey companies
- Research budgets can support off-the-shelf software applications and paper administration. Examples of low cost tools:
- Assessment Center, NIH Toolbox iPad App, PROMIS iPad App, Assessment Center API, web-based survey companies
- Research protocols that have unique needs are best suited to a custom software application solution. To learn more about our technology services, contact us>>
Use of HealthMeasures in clinical practice usually requires access to a measure’s final score at the time of the clinical encounter. This may or may not include integration of HealthMeasures in the electronic health record (EHR).
If EHR Integration is Required
- Some EHRs (e.g., Epic, Cerner, OpenEMR) include selected HealthMeasures. These measures are scored and viewable within a given patient’s record. Talk with your local EHR team about what is available to you.
- Some institutions have invested in integration within their local EHR (e.g., University of Rochester Medical Center, University of Utah Health Care, Washington University Orthopedics). This can be implemented using the Assessment Center API or SMART on FHIR apps. Talk with your local EHR team about what is available to you.
Integration of patient-completed measures in an EHR is challenging as it a) requires the coordination of clinicians, administrators, information technology specialists, and EHR staff and b) needs to be prioritized above other competing demands. Consequently, many clinicians find it more feasible to use a data collection tool alongside the EHR, not integrated within it.
Data Collection Tools for Use Alongside an EHR
- NIH Toolbox iPad and PROMIS iPad Apps and PROMIS iPad Apps for all NIH Toolbox and selected PROMIS measures.
- Assessment Center Application Programming Interface (API) is a tool to embed HealthMeasures, including CATs, in your own data collection systems. API users include REDCap, OBERD, and academic institutions. API users have access to all self- and proxy-report HealthMeasures.
- MyGiHealth is free iOS smartphone app that allows patients to report gastrointestinal (GI) symptoms using the PROMIS GI measures. Patients can forward their scores to physicians who use PROMIS to guide clinical decision-making.
Contact Us to learn more about using the Assessment Center Application Programming Interface (API). It makes available all self- and proxy-report HealthMeasures (PROMIS, Neuro-QoL™, ASCQ-Me®, NIH Toolbox Emotion) within your data collection system. This requires local IT staff effort and support.