Abstract
PurposeSupporting the capture and use of patient-reported outcomes (PROs) at the point-of-care enriches information about important clinical and quality of life outcomes. Yet the ability to scale PROs across healthcare systems has been limited by knowledge gaps around how to manage the diversity of PRO uses and leverage health information technology. In this study, we report learnings and practice insights from UW Medicine’s practice transformation efforts to incorporate patient voice into multiple areas of care.MethodsUsing a participatory, action research approach, we engaged with UW Medicine clinical and administrative stakeholders experienced with PRO implementation to inventory PRO implementations across the health system, characterize common clinical uses for PROs, and develop recommendations for system-wide governance and implementation of PROs.ResultsWe identified a wide breadth of PRO implementations (n = 14) in practice and found that nearly half (47%) of employed PRO measures captured shared clinical domains (e.g., depression). We developed three vignettes (use cases) that illustrate how users interact with PROs, characterize common ways PRO implementations support clinical care across the health system (1) Preventive care, (2) Chronic/Specialty care, and (3) Surgical/Interventional care), and elucidate opportunities to enhance efficient PRO implementations through system-level standards and governance.ConclusionsPractice transformation efforts increasingly require integration of the patient voice into clinical care, often through the use of PROs. Learnings from our work highlight the importance of proactively considering how PROs will be used across the layers of healthcare organizations to optimize the design and governance of PROs.
Highlights
Transformation to higher value, lower cost care is dependent on the ability of healthcare systems to leverage data that drive improvements in patient care and population health [1, 2]
Phase 1 (Inventory) To inventory current University of Washington (UW) Medicine Patient-reported outcomes (PROs) implementations, we identified needed data elements based on prior research [31] that describe health information technology implementation, including technology configuration and interface, user roles, workflow processes, and goals for data use
We identified 14 PRO implementations spanning diverse clinical settings (Table 2), which reflect a breadth of PROs in use prior to formalized, system-wide PRO implementation efforts by UW Medicine
Summary
Transformation to higher value, lower cost care is dependent on the ability of healthcare systems to leverage data that drive improvements in patient care and population health [1, 2]. Supporting the capture and use of patient-reported data enriches information about important outcomes and ensures the patient voice is central to care delivery. The utility of PROs depends on rigorous quality in the collection and stewardship of patientreported data to ensure timely access of accurate information [10, 11]. Coupling technology with widespread use of PROs across care settings can support efficiencies in care delivery while augmenting downstream quality improvement, population health, and payment policy [12]
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