0380 A Pilot Study to Test Patient-Reported Outcomes Visualization Methods in the EHR Note Template for Sleep Medicine Clinicians

Abstract

Abstract Introduction Patient-Reported Outcomes (PROs) are standardized assessments of patient-specific health measures for physical, mental, and social well-being reported directly by patients without provider interpretations. Providers use PROs to efficiently improve the quality of care and empower patients through structured communication. Patient factors are widely acknowledged to affect PROs; however, there is very little data on the effect of provider PRO visualization methods on patient outcomes. This pilot study compares PRO visualization methods to improve readability, provider satisfaction, and patient outcomes in a comprehensive sleep center. We hypothesize that detailed PRO with color-based formatting will improve the clinical diagnoses and provider satisfaction with PRO metrics. Methods Twenty-four sleep providers from the Sleep Disorders Center at Cleveland Clinic, consisting of physicians (n=14), fellows (n=3), and nurse practitioners (n=7), were randomly assigned to two equal groups. All sleep providers completed the online pre-intervention survey (71% female), and 23 providers (96%) completed the post-intervention survey four weeks after randomization. Survey questions utilizing 5-point Likert scales inquired about current use and perceived benefit of 3 PROs accompanying new visits: International Restless Leg Syndrome Scale (IRLS), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS). The standard presented only total scores, while the intervention group received detailed tables of IRLS, ISI, and ESS components with color-stratified total scores. ANCOVA statistical analysis was performed to compare satisfaction, usage, and clinical utility between groups over time. Results Current PRO templates were used by 79% of providers. PROs were reported as helpful or extremely helpful by 87% of providers, while only 38% were satisfied or extremely satisfied by the presentation. Compared to controls, the enhanced-visualization group scores improved but did not display significant differences in the likelihood of use (p=0.8), helpfulness (p=0.7), or overall satisfaction (p=0.9); utility in reaching diagnosis demonstrated a trend towards improvement (p=0.051). Conclusion PRO enhanced visualization did not demonstrate improvements in provider utility or satisfaction in this study. However, effects are likely limited by small sample sizes. Direct measurement of effects on test ordering and clinical diagnoses may provide further clarity. Future research is needed to enhance the usage of PROs to assess the decision-making process during clinical practice. Support (If Any)