Patient‐reported outcomes use during orthopaedic surgery clinic visits improves the patient experience

Abstract

Objectives: The Patient-Reported Outcomes Measurement Information System (PROMIS) is growing in popularity as healthcare shifts towards a value-based system. However, it remains unclear if PROMIS use improves the patient experience. The aim of the present study was to determine if PROMIS use as part of routine orthopaedic clinical care is associated with improved patient experience, as measured by the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) survey.Methods: All patient visits to an orthopaedic surgery clinic at a single academic medical centre between February 2015 and September 2016 were reviewed.Accounting for known patient factors that have an impact on clinic visit satisfaction, CGCAHPS scores were compared between patients who had PROMIS used as part of their routine care and those who had not had PROMIS used as part of their routine care. A p-value of <0.05 was considered significant.Results: A total of 8,607 patient visits fitted our inclusion criteria. Of these, surgeons elected not to use PROMIS in 8,422 patient encounters, leaving 185 patient visits in which PROMIS was actively used. When PROMIS was used, patients were significantly more likely to feel that the provider had spent enough time with them, to recommend this provider office to another patient and to rate the provider significantly higher on a scale from 0 to 10. Although not significant, a trend was found between use of PROMIS and whether a patient felt that a provider explained health information in way that the patient understood.Conclusions: PROMIS use in an orthopaedic clinic visit can have a positive impact on the patient experience, which is currently part of a number of alternative payment models.

Implementing models of care for musculoskeletal conditions in health systems to support value-based care

“…Systematic review evidence points to the likely benefit of using PROMs in healthcare [ 49 ]. PREMs indicate the patient's perspective on issues, such as access to care, how they were approached and included in their treatment decisions [ [49] , [50] , [51] ]. While satisfaction surveys have long been a part of MoCs, PREMs are relatively new with few tools to support their inclusion in clinical practice with local teams often developing their own.…”

Transforming the Orthopaedic Patient Experience Through Telemedicine

“…Wounds can be examined over video and range of motion, strength, and gait can be assessed through the surgeon coaching patients through the correct movements. In addition, concerns can be shared, and PROMs can be collected and discussed, which has been shown to be associated with increased patient satisfaction ( 8 ). However, it remains crucial to ensure that only appropriate orthopaedic patients are provided care via telemedicine.…”

Effect of assessment administration method and timing on patient‐reported outcome measures completion and scores: Overview and recommendations

“…Further, technology barriers can cause notable strain, as poor integration with electronic health records (EHRs) limits the practicality and use of PROMs in clinical practice (Wagle, 2017). Despite these barriers, the benefits of using PROMs, especially with the rise of value‐based health care, are plentiful—improved patient experience (Bernstein et al, 2019), assistance in shared decision‐making (Briffa, 2018), and enriched understanding of patients likely to succeed with certain interventions (Bernstein et al, 2020; Ho et al, 2016). Thus, robust implementation of PROMs within health‐care systems is warranted, and successful large‐scale examples noted in the literature may provide guidance (Biber et al, 2017; Papuga et al, 2018).…”