Capturing Relevant Patient Data in Clinical Encounters Through Integration of an Electronic Patient-Reported Outcome System Into Routine Primary Care in a Boston Community Health Center: Development and Implementation Study.

Stephanie Loo,Justin Mcreynolds,Chris Grasso,William Lober,Jessica Glushkina,Heidi Crane,Kenneth H Mayer

doi:10.2196/16778

Abstract

BackgroundElectronic patient-reported outcome (ePRO) systems can improve health outcomes by detecting health issues or risk behaviors that may be missed when relying on provider elicitation.ObjectiveThis study aimed to implement an ePRO system that administers key health questionnaires in an urban community health center in Boston, Massachusetts.MethodsAn ePRO system that administers key health questionnaires was implemented in an urban community health center in Boston, Massachusetts. The system was integrated with the electronic health record so that medical providers could review and adjudicate patient responses in real-time during the course of the patient visit. This implementation project was accomplished through careful examination of clinical workflows and a graduated rollout process that was mindful of patient and clinical staff time and burden. Patients responded to questionnaires using a tablet at the beginning of their visit.ResultsOur program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model in terms of applying technological innovation to streamline clinical processes and improve patient care.ConclusionsOur program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model for application of technological innovation to streamline clinical processes and improve patient care.

Highlights

Electronic patient-reported outcome systems can improve health outcomes by detecting health issues or risk behaviors that may be missed when relying on provider elicitation [1]
Our program demonstrates that implementation of an Electronic patient-reported outcome (ePRO) system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care
The available surveys were, namely, learning needs assessment, Patient Health Questionnaire-9 (PHQ-9)/PHQ-9 modified for Adolescents (PHQ-A), smoking and tobacco, fall risk assessment, intimate partner violence, Alcohol Use Disorders Identification Test (AUDIT)-C alcohol screen, Drug Abuse Screening Test-10 (DAST-10), Generalized Anxiety Disorder-7 (GAD-7), Edinburgh postpartum screen, patient portal sign-up

Summary

Introduction

Electronic patient-reported outcome (ePRO) systems can improve health outcomes by detecting health issues or risk behaviors that may be missed when relying on provider elicitation [1]. The use of computerized assessments has the potential to further improve patient-provider communication and overall satisfaction though systematic data collection [2]. The ePRO system was developed for research in 2007, through the Center for AIDS Research Network of Integrated Clinical Systems’ collection of HIV-specific PROs [3,4]. Fenway Health (hereafter, referred to as “Fenway”) is a national leader in HIV care, research, and culturally responsive care to lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients [5]. The ePRO integration project was implemented across all primary care clinic sites of Fenway, an urban federally qualified community health center. The pilot project began in 2013, with full implementation and rollout occurring across three primary care clinic sites at Fenway from 2014 to 2015.

Methods

Results

Conclusion