Background Electronic patient-reported outcome (ePRO) systems can improve health outcomes by detecting health issues or risk behaviors that may be missed when relying on provider elicitation. Objective This study aimed to implement an ePRO system that administers key health questionnaires in an urban community health center in Boston, Massachusetts. Methods An ePRO system that administers key health questionnaires was implemented in an urban community health center in Boston, Massachusetts. The system was integrated with the electronic health record so that medical providers could review and adjudicate patient responses in real-time during the course of the patient visit. This implementation project was accomplished through careful examination of clinical workflows and a graduated rollout process that was mindful of patient and clinical staff time and burden. Patients responded to questionnaires using a tablet at the beginning of their visit. Results Our program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model in terms of applying technological innovation to streamline clinical processes and improve patient care. Conclusions Our program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model for application of technological innovation to streamline clinical processes and improve patient care.
BACKGROUND Electronic patient reported outcomes (ePROs) can improve health outcomes by detecting health issues or risk behaviors that may be missed when relying on provider elicitation. OBJECTIVE To implement an ePRO system asking key health questionnaires in an urban community health center (CHC) in Boston, Massachusetts. METHODS An ePRO system asking key health questionnaires was implemented in an urban CHC in Boston, Massachusetts. The system was integrated with the electronic health record so medical providers could review and adjudicate patient responses in real-time during the course of the patient visit. This implementation project was accomplished through careful examination of clinical workflows and a graduated roll-out process that was mindful of patient and clinical staff time and burden. Patients responded to questionnaires using a tablet at the beginning of their visit. RESULTS The system was tested on the patient panel of twenty-five providers. ePRO session completion totals increased considerably, from 2,428 completed sessions in 2014 to 19,650 in 2018. In CY 2018, via ePRO, 41% of patients reported mild-to-severe depression, 35% mid-to-severe anxiety, 35% problem alcohol use, 4.4% positive DAST (drug use) score, and 10% current or some day tobacco use. CONCLUSIONS Our program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model in applying technological innovation to streamline clinical processes and improve patient care.
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