Challenges and Opportunities in Using Patient-reported Outcomes in Quality Measurement in Rheumatology

Wahl, Elizabeth; Yazdany, Jinoos

doi:10.1016/j.rdc.2016.01.008

Cited by 12 publications

(11 citation statements)

References 30 publications

(46 reference statements)

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“…As commonly found, the main challenge observed in this case study stems from the many limitations of current medical information systems [ 2 , 6 , 11 ]. This is likely to be a healthcare system-level problem; evidence is emerging of other systems more effectively integrating PROMs into routine IT supporting services [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

An alternative approach to implementing patient-reported outcome measures

Gibbons

Fitzpatrick

2018

Pilot Feasibility Stud

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BackgroundObtaining patients’ views of their health and outcomes of interventions utilising patient-reported outcome measures (PROMs) is a well-established method, but there is still uncertainty about the impact of PROMs on services and patient care. Studies are now needed of alternative ways of implementing PROMs. This paper describes a case study of the introduction of a new PROM to assess musculoskeletal (MSK) problems, known as the Musculoskeletal Health Questionnaire (MSK-HQ).MethodsFollowing an invitation from the Arthritis Research UK (ARUK), 11 groups and organisations agreed to become ‘partners’ in piloting the MSK-HQ. Twenty-nine interviews and a focus group were carried out with key informants from the partners. Interviews were supplemented with some documentary evidence of partners’ meetings. Data were coded and analysed with NVivo software V.10. Analysis was carried out via a framework method.ResultsParticipants reported positive evidence that the MSK-HQ is feasible and practical for use in patient care with content that helped health professionals identify and address patients’ main presenting problems. Although mediated and reported through health professionals’ judgments, the questionnaire was also seen as very relevant and acceptable to a wide spectrum of patients.There was also broad support for the view that whilst the MSK-HQ is relevant to individual patient care, it could also, when aggregated, reflect the experiences of patients as a group and be used as evidence for third parties concerned with the provision and commissioning of services.The main difficulties revealed by the case study were in the form of logistics and sustainability. It was recognised that electronic systems would be more effective for administration and data processing but they were not feasible to develop and implement within reasonable timelines and available budgets. A sustainable approach to using the PROM required significant long-term commitment of budget, a coherent system, and active support from diverse organisations.ConclusionsThe current study supports the view that a bottom-up approach is a promising method to generate PROM-related insights that are relevant to patients and health professionals. The partnership approach to developing and using PROMs may have wider relevance and potential as a model of implementation.Electronic supplementary materialThe online version of this article (10.1186/s40814-018-0289-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

An alternative approach to implementing patient-reported outcome measures

Gibbons

Fitzpatrick

2018

Pilot Feasibility Stud

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“…Thus, increased health facility capacity, initiatives for patient education, and strategies for weight control—providing benefits to a high number of individuals at relatively low cost—are at least as urgently needed in LA as access to high cost biologic therapies. In keeping with this assumption, patient-reported outcomes (PROs) are increasingly relevant to assess the quality and effectiveness of management strategies and to facilitate decisions about whether or not they should be incorporated in health care [ 10 ]. Health systems in LA may thus improve assistance and optimize costs using PRO experience.…”

Section: Medications and Health Facilitiesmentioning

confidence: 99%

Latin-American challenges and opportunities in rheumatology

Rocha

2017

Arthritis Res Ther

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The importance of diseases to mankind is very similar worldwide. However, social and environmental issues, not to mention political and individual aspects, affect the prevalence and management of diseases and their outcomes. I present a brief and tentative comment to illustrate that the Latin-American rheumatology community, despite relevant gains in recent years, has some challenges to face in order to improve patient care in our region.

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“…Target populations most likely to benefit from PRO use include medically and socially complex patients, and individuals for whom repeated measures of function help gauge recovery [434445]. The National Quality Forum and others have called for research on best practices in this area [1464748]. …”

Section: Discussionmentioning

confidence: 99%

Data Management for Applications of Patient Reported Outcomes

Bayliss

Tabano

Gill

et al. 2018

eGEMs

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Context:Patient reported outcomes (PROs) are one means of systematically gathering meaningful subjective information for patient care, population health, and patient centered outcomes research. However, optimal data management for effective PRO applications is unclear.Case description:Delivery systems associated with the Health Care Systems Research Network (HCSRN) have implemented PRO data collection as part of the Medicare annual Health Risk Assessment (HRA). A questionnaire assessed data content, collection, storage, and extractability in HCSRN delivery systems.Findings:Responses were received from 15 (83.3 percent) of 18 sites. The proportion of Medicare beneficiaries completing an HRA ranged from less than 10 to 42 percent. Most sites collected core HRA elements and 10 collected information on additional domains such as social support. Measures for core domains varied across sites. Data were collected at and prior to visits. Modes included paper, clinician entry, patient portals, and interactive voice response. Data were stored in the electronic health record (EHR) in scanned documents, free text, and discrete fields, and in summary databases.Major themes:PRO implementation requires effectively collecting, storing, extracting, and applying patient-reported data. Standardizing PRO measures and storing data in extractable formats can facilitate multi-site uses for PRO data, while access to individual PROs in the EHR may be sufficient for use at the point of care.Conclusion:Collecting comparable PRO data elements, storing data in extractable fields, and collecting data from a higher proportion of eligible respondents represents an optimal approach to support multi-site applications of PRO information.

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Challenges and Opportunities in Using Patient-reported Outcomes in Quality Measurement in Rheumatology

Cited by 12 publications

References 30 publications

An alternative approach to implementing patient-reported outcome measures

An alternative approach to implementing patient-reported outcome measures

Latin-American challenges and opportunities in rheumatology

Data Management for Applications of Patient Reported Outcomes

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