PSU19 Promoting Quality - Preliminary Results of a CROSS Sector Implementation of Patient-Reported Outcomes to Improve Quality of Care for Knee and HIP Replacements

Abstract

PROMoting Quality investigates the potential of integrating the patient perspective via digital Patient-Reported Outcome Measures (PROMs) into the patient pathway after knee and hip replacements. Early detection of adverse recovery pathways are expected to yield cost-efficient improvements of care quality. As an initiative of the government funded “Innovationsfonds”, the goal of the study is to transfer the study design into German standard care. PROMoting Quality is a two-arm multicenter randomized controlled trial. Patients from nine German hospitals are digitally accompanied from hospital admission to 12 months after discharge by regular PROM questionnaires (e.g., EQ-5D-5L, HOOS-PS, KOOS-PS). Algorithm-based thresholds alert study assistants, should patients not recover in line with expected recovery. The study assistants contact patients and their physicians to investigate and, if needed, adjust the post-treatment protocol [1]. Two major insurers will provide claims data at patient level to evaluate cost-effectiveness. Preliminary Patient enrollment was completed in December 2020 with a sample size of >8,000. To date, patients have provided 9,000 responses to follow-up questionnaires (1, 3, and 6 months post-discharge), resulting in a return rate of 85%. Depending on follow-up month, 15 - 30% of patients in the intervention group have triggered alerts. Concurrently 30% of patients have engaged in conversations regarding their PROMs with their post-treatment physicians. Additionally, surveys among study assistants report time-saving and robust digital workflows with high acceptance rates of PROM-based interventions among physicians involved. The study allows participating hospitals and insurers to delve deeper into the systematic collection of PROMs in line with the principles of value-based healthcare. Preliminary results based on excellent patient engagement rates indicate that PROMoting Quality can set a blueprint for using PROMs as an intervention and quality measurement tool in standard care. [1] Kuklinski et al. (2020) https://doi.org/10.1186/s13063-020-04252-y.