Use of Patient-Reported Outcomes in the Context of Different Levels of Data*

Rolfson, Ola; Rothwell, Alastair G.; Sedrakyan, Art; Chenok, Kate Eresian; Bohm, Éric; Bozic, Kevin J.; Garellick, Göran

doi:10.2106/jbjs.k.01021

Cited by 70 publications

(77 citation statements)

References 26 publications

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“…For example, annual, aggregate PROMs for total hip replacement care in every hospital in Sweden are publicly reported and compared and are an integral aspect of the national and regional quality monitoring programs. 25 In the United States, CMS began public reporting of riskadjusted 30-day readmissions and 90-day all cause complications after TJR by hospital in 2013 and 2014, respectively, and efforts are underway to evaluate the inclusion of PROMs as part of overall quality monitoring. 26 Both the National Quality Foundation and CMS endorse the use of PROMs for quality monitoring and in value payment programs.…”

Section: Use 2 Value To Hospital Leaders and Cliniciansmentioning

confidence: 99%

Framework To Guide The Collection And Use Of Patient-Reported Outcome Measures In The Learning Healthcare System

Franklin¹,

Chenok²,

Lavalee³

et al. 2017

eGEMs

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Background:Web-based collection of patient-reported outcome measures (PROMs) in clinical practice is expanding rapidly as electronic health records include web portals for patients to report standardized assessments of their symptoms. As the value of PROMs in patient care expands, a framework to guide the implementation planning, collection, and use of PROs to serve multiple goals and stakeholders is needed. Methods:We identified diverse clinical, quality, and research settings where PROMs have been successfully integrated into care and routinely collected and analyzed drivers of successful implementation. Findings are based on key informant interviews with 46 individuals representing 38 organizations, of whom 40 participated in a webinars series, and 25 attended an in-person workshop designed to enable broad stakeholder input, review and refinement of the proposed PROMs implementation model. Stakeholders identified differing uses of PROMs to support: 1) individual patient care decisions, 2) quality improvement initiatives, 3) payer mandates, and 4) population health and research. Results:The implementation framework and steps that are consistently identified by stakeholders as best practices to guide PROM capture and use are described. Of note, participants indicate that webbased informatics tools are necessary but not sufficient for PROM use, suggesting that successful PROM implementation requires integration into clinic operations and careful planning for user's analytic needs. Each of the four identified uses may require implementation modifications at each step to assure optimal use. Conclusions:The proposed framework will guide future PROM implementation efforts across learning health care systems to assure that complete PROMs are captured at the correct time, and with associated risk factors, to generate meaningful information to serve diverse stakeholders.

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Section: Use 2 Value To Hospital Leaders and Cliniciansmentioning

confidence: 99%

Framework To Guide The Collection And Use Of Patient-Reported Outcome Measures In The Learning Healthcare System

Franklin¹,

Chenok²,

Lavalee³

et al. 2017

eGEMs

View full text Add to dashboard Cite

show abstract

“…National registries that collect data from hospitals only to estimate revision rates must assure that all hospitals participate or some revisions will be missed. Recently, a subset of national registries (England and Wales, New Zealand) began to collect PROs directly from patients [9]. However, this process has different challenges and limitations.…”

Section: How Do We Get There?mentioning

confidence: 99%

Integrating Patient-reported Outcomes Into Orthopaedic Clinical Practice: Proof of Concept From FORCE-TJR

Ayers

Zheng

Franklin

2013

Clinical Orthopaedics &Amp; Related Research

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Background Good orthopaedic care requires a knowledge of the patient's history of musculoskeletal pain and associated limitations in daily function. Standardized measures of patient-reported outcomes (PROs) can provide this information. Integrating PROs into routine orthopaedic patient visits can provide key information to monitor changes in symptom severity over time, support shared clinical care decisions, and assess treatment effectiveness for quality initiatives and value-based reimbursement.

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“…A recent review of the use of PROs in registries concluded: ''omitting patient-reported outcomes precludes us [surgeons] from having a full understanding of the factors that contribute to pain relief, restoration of function, and patient satisfaction'' [20].…”

Section: Where Are We Now?mentioning

confidence: 99%

“…PROs also capture presence of persistent pain and unsatisfactory functional gains in patients who fail to achieve the desired outcome. Some of the international TJA registries now incorporate PROs that emphasize the patient's perception of pain and physical function [20], and recent evidence-based research has called attention to the value of incorporating PROs in national joint registries [19].…”

Section: Introductionmentioning

confidence: 99%

Incorporating Patient-reported Outcomes in Total Joint Arthroplasty Registries: Challenges and Opportunities

Franklin¹,

Harrold²,

Ayers³

2013

Clinical Orthopaedics &Amp; Related Research

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Background Total joint arthroplasty (TJA) registries traditionally have focused on implant longevity and rates of revision surgery. Registries would benefit from the addition of standardized patient-reported outcomes (PROs) such as pain relief and improved physical function. However, PROs have not been routinely adopted, and their incorporation into TJA registries presents challenges. Questions/purposes We review current PRO use by existing national registries, challenges to integrating PROs in national registries, lessons from national registries that have integrated PROs, and suggestions to guide future adoption of PROs. Methods We conducted a literature search of papers addressing PRO use in national knee and hip arthroplasty registries, resulting in 15 articles. These publications were supplemented by discussions with thought leaders from international registries.

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Use of Patient-Reported Outcomes in the Context of Different Levels of Data*

Cited by 70 publications

References 26 publications

Framework To Guide The Collection And Use Of Patient-Reported Outcome Measures In The Learning Healthcare System

Framework To Guide The Collection And Use Of Patient-Reported Outcome Measures In The Learning Healthcare System

Integrating Patient-reported Outcomes Into Orthopaedic Clinical Practice: Proof of Concept From FORCE-TJR

Incorporating Patient-reported Outcomes in Total Joint Arthroplasty Registries: Challenges and Opportunities

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