PRM8 - CLINICAL APPLICATION AND USAGE OF PATIENT REPORTED OUTCOME MEASURES IN AN ORTHOPAEDIC OUTPATIENT SETTING

Abstract

The objective is to outline collection methods and clinical usage of PROMIS measures in the orthopaedic outpatient setting of an academic medical center. The orthopaedic outpatient clinics of an academic medical center implemented the collection of PROMIS assessments in the summer of 2015. Orthopaedic faculty and midlevel providers were educated on the standard usage of PROMIS assessments and provided suggestions for adoption in clinical practice. Presently, PROMIS assessments are collected for the outpatient clinical visits of 60 orthopaedic faculty and 17 midlevel providers across 7 separate locations in a metropolitan area. PROMIS modules vary based on the population and the providers’ subspecialty. Assessments are delivered in computer adaptive testing (CAT) format and results are delivered in real time to the electronic medical record (EMR).This allows clinical providers to view a patient’s PROMIS score in the patient chart prior to the initiation of the patient visit. Pediatric PROMIS depression administration prompted parental complaints and resulted in our switch to delivery of pediatric peer relationships. Formal patient feedback regarding PROMIS scores has recently been delivered regarding adult Depression and Anxiety scores. PROMIS has largely been incorporated into clinical practice successfully across practice locations. Depression CAT’s selectively caused more complaints for pediatric visits and that assessment was then discontinued. At this time, clinicians indicate that they may review Physical Function scores but no thresholds or rules are followed to allow those scores to change treatment. Given the inter-relationship between physical and mental health, our clinicians have now formulated formal handouts for patients to address heightened Anxiety and/or Depression scores at the time of clinical care. Such response to mental health scores was delayed from the start of survey use as processes required development and responses were established with additional input from the University’s Psychiatry Department and legal team.