The objective of this research was to assess the implementation of collecting patient-reported outcomes data in the outpatient clinics of a large academic hospital and identify potential barriers and solutions to such an implementation. Three PROMIS computer adaptive test instruments, (1) physical function, (2) pain interference, and (3) depression, were administered at 23,813 patient encounters using a novel software platform on tablet computers. The average time to complete was 3.50 ± 3.12 min, with a median time of 2.60 min. Registration times for new patients did not change significantly, 6.87 ± 3.34 to 7.19 ± 2.69 min. Registration times increased for follow-up (p = .007) from 2.94 ± 1.57 (p < .01) min to 3.32 ± 1.78 min. This is an effective implementation strategy to collect patient-reported outcomes and directly import the results into the electronic medical record in real time for use during the clinical visit.

Background Patient-reported outcome measures such as the Patient-Reported Outcomes Measurement Information System (PROMIS) allow surgeons to evaluate the most important outcomes to patients, including function, pain, and mental well-being. However, PROMIS does not provide surgeons with insight into whether patients are able to successfully cope with their level of physical and/or mental health limitations in day-today life; such understanding can be garnered using the Patient-acceptable Symptom State (PASS). It remains unclear whether or not the PASS status for a given patient and his or her health, as evaluated by PROMIS scores, differs based on sociodemographic One of the authors (DNB) certifies that he has received grants from Alpha Omega Alpha, outside the submitted work. One of the authors (JFB) certifies that she has received payments or benefits in an amount less than USD 10,000 from PROMIS Health Organization (Evanston, IL, USA), payments or benefits in an amount less than USD 10,000 from the American Orthopaedic Foot & Ankle Society (Rosemont, IL, USA), grants and personal fees in amount of USD 10,000 to USD 100,000 from Cartiva (Alpharetta, GA, USA), payments or benefits in an amount less than USD 10,000 from Clinical Orthopaedics and Related Research® (Philadelphia, PA, USA), personal fees in an amount less than USD 10,000 from DJ Orthopaedics (Dallas, TX, USA), grants and personal fees in an amount less than USD 10,000 from Ferring Pharmaceuticals (Parsippany, NJ, USA), personal fees and benefits in an amount less than USD 10,000 from Nextremity Solutions Inc (Warsaw, IN, USA), personal fees in an amount of USD 10,000 to USD 100,000 from Stryker (Kalamazoo, MI, USA), payments and benefits in an amount less than USD 10,000 from Techniques in Foot and Ankle Surgery (Philadelphia, PA, USA), grants and personal fees in an amount less than USD 10,000 from Wright Medical Technology Inc (Memphis, TN, USA), personal fees in an amount less than USD 10,000 from Zimmer (Warsaw, IN, USA), outside the submitted work. Other authors (KM, CD, KF, and JRH) certify that they have no commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.