A clinical perspective on electronically collecting patient-reported outcomes at the point-of-care for overactive bladder

Abstract

Introduction: Collecting patient-reported outcomes (PROs) can inform the treatment and management of overactive bladder (OAB). However, collecting these data at the point-of-care can be timeconsuming and have a negative impact on a clinic's workflow. The purpose of this study was to pilot a digital system for collecting PROs at the point-of-care and qualitatively assess clinicians' perspectives in terms of the system's impact on the delivery of care for OAB. Methods: Patients visiting a urology clinic for OAB completed several PRO instruments using a tablet while awaiting assessment. Clinicians reviewed their responses using a digital dashboard during clinical encounters. Qualitative interviews were conducted with the clinicians, to assess the collection system's impact in terms of: 1) logistics, 2) workflow; 3) patient communication; 4) influence on clinical decisions; 5) user experiences; and 6) the care model. Results: Six interviews were conducted and thematic saturation was met, with several themes emerging. All participants were generally positive regarding the use of the digital collecting system. Participants felt that the dashboard improved workflow and enhanced communication with patients, but it was not thought to be any more influential on clinical decision-making than conventional collection methods. Several aspects of the digital PRO collection system were identified as needing improvement. Conclusions:The digital PRO collection system used at the pointof-care had a positive impact on the delivery of care for OAB. The results from this study could provide insight to other urologists who are interested in collecting PROs in their clinic. IntroductionTreating overactive bladder (OAB) can be challenging, in part because clinical endpoints are not well-defined. 1 Additionally, objective assessment tools used to measure biologic responses to interventions do not inform clinicians as to whether those interventions made a noticeable difference to the patient.2 Like many chronic conditions, interventions for OAB are aimed more at minimizing symptoms to a level tolerable to the patient. Symptom severity will differ by patient, as will the impact those symptoms have on a patients' quality of life.3 If this impact can be assessed, clinicians can meaningfully adjust their management of the patient's OAB.One way to assess and quantify the severity of symptoms related to OAB is through the use of patient-reported outcomes (PROs). Originally designed for use in randomized control trials, PROs directly assess a patient's health, functional impairments and disabilities, and severity of symptoms using standardized survey instruments. Advancements in PRO instrument development and technology are driving more clinicians to use PROs as part of a comprehensive approach to the delivery of care. 4 Specific to the treatment of OAB, the Fourth International Consultation on Incontinence recommendations regarding effective care of lower urinary tract symptoms (LUTS) includes assessing patient symptoms and health-relat...

Investigating Analytics Dashboards’ Support for the Value-based Healthcare Delivery Model

“…Our analyses shows that in several cases dashboards were used as to monitor the trend of the data and to improve the HC services and quality of care [31]- [38]. Desantis et al (2016) [31] in their study to monitor and improve the quality of life among patients with overactive bladder used a dashboard to track patients' quality of life longitudinally.…”

“…Our analyses shows that in several cases dashboards were used as to monitor the trend of the data and to improve the HC services and quality of care [31]- [38]. Desantis et al (2016) [31] in their study to monitor and improve the quality of life among patients with overactive bladder used a dashboard to track patients' quality of life longitudinally. In Germany at the University Hospital Leipzig, dashboard employed on head and neck tumour board for real-time monitoring and improving the care of patients [35], the designed dashboards had information regarding patient metric (e.g.…”

“…Source Primary care practitioner [40]- [42], [45], [47]- [49], [52] General Practitioner [34] Clinician [9], [17]- [21], [31], [46], [50], [55], [56], [58], [59] Physician [5], [35], [39], [42], [44], [53] Nurse [4], [33], [36], [38], [42], [50] Medical Staff [4], [6], [7], [19], [21], [33], [37], [39], [43], [50], [51], [57] Pharmacist [40], [60] Administrator and Managers [36], [53], [57] Patient [4], [17]- [21], [52],…”

“…Name Source Identified Cognitive Activities Analytical reasoning [6], [39], [41], [53] Decision Making [31], [37], [40], [42], [44]- [46], [54], [55] Knowledge discovery [51] Planning [5] Problem Solving [50] Sense Making [33]…”

“…Better Collaboration and Communication [5], [7], [17], [31], [32], [38], [48], [51] Performance Improvement [5], [7], [18], [19], [36], [37], [41], [44], [51] Better Documentation [38], [41] Time Improvement [44], [51], [52] Service Quality Improvement [6], [7], [31], [33], [38]- [40], [48], [49], [51] Efficiency Improvement [19], [21], [43], [54], [58] Efficient Data Access [5], [32]- [35], [39], [41], [44], [53] Better Data Monitoring [4], [9], [18], [34], [39], [41], [59]…”