When & How to Assess
Assessment Time Points Should Match Aims of Use
How the patient-reported outcome (PRO) measure will be used in patient care should guide when assessments happen. Austin et al (2020) provide a helpful figure (see below). Here a screening measure is only needed annually whereas monitoring a symptom over time requires assessment at every clinic visit. Comparing a patient to the overall population may require fixed assessment times every 6 months which may not correspond with a clinic visit. Know how the PRO measure will be used. Learn more>>
- Identify when scores will be used in patient care.
- Align assessment time points so that scores are available when needed.
- 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 completed between clinic visits allow for more frequent assessment and less disruption to clinic workflow. However, it may not reflect how a person is doing on the day of a clinic visit.
- Measures completed between clinic visits may require a process for providers to follow-up with patients who are having problems or concerns.
Figure: Assessment aim informs measure requirements and assessment time points
Reprinted with permission.
Austin, E., LeRouge, C., Hartzler, A.L. et al. Capturing the patient voice: implementing patient-reported outcomes across the health system. Qual Life Res, 29, 347–355 (2020). https://doi.org/10.1007/s11136-019-02320-8
When to Assess
For information on when and how often to assess PROs, watch this 4 minute video.
Automate Assessment Triggers
- Automated assessment triggers within the administration platform reduces the burden on providers and staff.
- Triggers can include:
- A fixed schedule from an identified event (e.g., 2 weeks after total knee replacement surgery)
- New patient versus established patient
- Procedure or diagnosis (e.g., ICD or CPT code)
- Patient demographics (e.g., age, gender)
- A combinations of these factors
- Set the amount of time an assessment will be available (e.g., 3 days before and 1 day after an appointment)
Identify where patients will be when they complete an assessment (e.g., at home, waiting room). Review Minimize Workflow Disruptions to develop a strategy.
How to Assess
Facilitate Use of Patient Portals
Patient-Reported Outcomes are increasingly available within electronic health records (EHRs). 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. Strategies to maximize use of the patient portal include:
- 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
Enable Multiple Data Capture Options
Not all patients will complete an assessment through the EHR's patient portal. Multiple implementation sites have identified having multiple data capture options available as critical to ensure most patients can complete an assessment. Learn more>>
Utilize a non-EHR Administration Platform
Web-based and mobile app administration platforms can be used to collect HealthMeasures alongside the EHR. To select a platform, know the required features, regulations at your site (e.g., HIPAA compliance), and financial and personnel resources. Learn more>>