Abstract
AimPatient-reported outcomes (PROs) have traditionally been implemented through a manual process of paper and pencil with little standardization throughout a Healthcare System. Each practice has asked patients specific questions to understand the patient’s health as it pertains to their specialty. These data were rarely shared and there has not been a comparison of patient’s health across different specialty domains. We sought to leverage interoperable electronic systems to provide a standardization of PRO assessments across sites of care.MethodsUniversity of Utah Health is comprised of four hospitals, 12 community clinics, over 400,000 unique annual patients, and more than 5000 providers. The enterprise wide implementation of PROs started in November of 2015. Patients can complete an assessment at home via email, or within the clinic on a tablet. Each specialty has the opportunity to add additional specialty-specific instruments. We customized the interval with which the patient answers the assessments based on specialty preference in order to minimize patient burden, while maximizing relevant data for clinicians.ResultsBarriers and facilitators were identified in three phases: Pre-implementation, Implementation, and Post-implementation. Each phase was further broken down into technical challenges, content inclusion and exclusion, and organizational strategy. These phases are unique and require collaboration between several groups throughout the organization with support from executive leadership.DiscussionWe are deploying system-wide standard and customized PRO collection with the goals of providing better patient care, improving physician-patient communication, and ultimately improving the value of the care given. Standardized assessment provides any clinician with information to quickly evaluate the overall, physical and mental health of a patient. This information is available real time to aid in patient communication for the clinician.
Highlights
In recent years, there has been an increased interest in understanding the value and use of Patient Reported Outcomes (PROs) in clinical care [1,2,3,4]
We created our own platform to allow for customization and reduce vendor-imposed constraints. My Evaluation (mEVAL) is built within our Enterprise Data Warehouse with 3.0 total full-time equivalent (FTE) personnel allocated for maintenance and continued implementation
We are below our goal with 47% of patients complete a mEVAL assessment, 17% completing them at home and 30% completing them in clinic
Summary
There has been an increased interest in understanding the value and use of Patient Reported Outcomes (PROs) in clinical care [1,2,3,4]. Technical and logistical challenges have limited deployment of PROs broadly within health care systems. At University of Utah Health, we are implementing the collection, reporting, and analytical use of PROs throughout the clinical enterprise. PROs collection is in place for about 75% of the ambulatory encounters within our system. Facilitators of this program include collaborating with our Information Technology (IT) team to create a home-grown application, integration of data into our Electronic Health Record (EHR), and provider champions
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