Clinical Case Studies

Neuro-QoL™ Measures Collected at Cleveland Clinic

Researchers at Cleveland Clinic developed a suite of iPad-based assessments that are now shared across MS PATHS (Multiple Sclerosis Partners Advancing Technology and Health Solutions) centers. In addition to patient history, the assessments include Neuro-QoL measures. The measures are self-administered prior to routine appointments and, over time, document individuals’ trajectories on important health-related quality of life outcomes.

Previous work documented the validity of using the Neuro-QoL measures in samples of persons with MS. In a sample of persons with MS, the scales demonstrated good reliability, concurrent validity, known groups validity and responsiveness.

PROMIS Measures Collected in Routine Clinical Care at a Children’s Hospital

The Cincinnati Children’s Hospital Medical Center (CCHMC) implemented system-wide assessment with PROMIS and other PRO measures. Across clinics, their completion rate is 75%. Their experience resulted in a publication (Gerhardt et al., 2018) describing recommendations for successful implementation including identification of a physician or nurse champion, matching measures with clinical need, knowing the meaning of scores including when and how to intervene, training providers and staff, and monitoring completion rates. Further discussion by (Lavallee et al., 2018) highlighted the need for such case studies.

PROMIS CATs Collected at University of Utah Health (mEVAL)

The University of Utah integrated PROMIS computer adaptive tests (CATs) in their electronic health record (EHR) as part of their mEVAL initiative. Patients are asked to complete an assessment through the EHR's patient portal or on a tablet computer at an appointment. CATs are automatically scored and results are available to care providers within the EHR. Biber and colleagues (2018) described the barriers and facilitators for this implementation.

PROMIS CATs Collected at Michigan Medicine

Within Orthopaedic Surgery at Michigan Medicine, patients are asked to complete a battery of PROMIS computer adaptive tests (CATs) at each visit. Administration, scoring, and reporting is integrated in the electronic health record using the Epic PROMIS CAT Application. Patient engagement efforts have focused on increasing enrollment and utilization of the electronic health record’s patient portal as well as providing standardized scripts for staff to convey the rationale and importance of the assessment. For more information, contact Michigan Medicine’s Quality Department.

Systematic Literature Review of Implementations in Oncology

In a 2018 review, Anatchkova and colleagues conducted a systematic literature review of implementation of patient-reported outcomes in oncology care. Using the 2015 ISOQOL User’s Guide for Implementing Patient-Reported Outcomes Assessment in Clinical Practice to create a framework for evaluation, they reviewed 36 publications. Most (n=29, 81%) were reports on intervention or feasibility research. Only three studies described ongoing routine PRO assessment to manage patient care outside of the scope of a research study. Aims for PRO collection were varied including improving symptom monitoring, patient-provider communication, patient-centeredness of care, and quality of care. Only about half of the studies reported intervention results on patient outcomes. The authors also reported a need for guidelines for interpreting PRO scores and for strategies to address concerning PRO scores “...particularly when the identified needs of patients extend beyond the expertise or training found in a routine oncology clinical practice such as depression or lack of social support.” Learn more>>

Epic PROMIS App in Clinical Practice

Multiple healthcare organizations are successfully collecting HealthMeasures through the PROMIS Epic app. Assessments including computer adaptive tests (CATs), profiles, and short forms can be triggered by scheduled appointments with scores available in real time. Learn more>>