First steps in PROMs and PREMs collection in Wales as part of the prudent and value-based healthcare agenda

Abstract

Purpose Patients are experts in their own health and should be treated as equal partners in their care. Patient-reported outcome measures (PROMs) are an effective way of gathering patient feedback and can facilitate effectiveness and cost-effectiveness analysis to improve decision making and service improvement. The PROMs, PREMs & Effectiveness Programme was initiated in 2016 and aimed to develop an electronic platform to facilitate collection of PROMs and Patient-reported experience measures (PREMs) from secondary care patients across Wales. Methods We worked with all Health Boards in Wales, the NHS Wales Informatics Service (NWIS), and Cedar (a healthcare technology research centre) to identify and meet technical requirements to develop a platform which is fit for purpose. Patient groups were included throughout the development to gather feedback and for extensive testing. Clinical teams helped identify the most appropriate tools, with licences, translations and electronic formatting issues being managed centrally. Results The developed platform is integrated with patient administration systems minimising the need for manual input, with processes in place to allow automatic collection triggers according to nationally agreed schedules. We have over 30 nationally agreed PROMs ‘pathways’ with over 110,000 PROMs collected to date. Responses are fed back to clinicians via the electronic patient record and to each health board via feeds to the national data warehouse, making data easily accessible to different teams, maximising use and application. Discussion The national platform has provided a co-ordinated approach to PROMs collection in Wales, offering an effective means of communicating with patients outside the traditional clinic visit.

The implementation of value-based healthcare: a scoping review

“…In 15 articles, the concept of VBHC was defined by reference to its value or its goals only, without defining the VBHC concept. Six conceptualized value in VBHC [26][27][28][29][30][31], six conceptualized goals of VBHC [7,[32][33][34][35][36] and three conceptualized both value and goals in VBHC [37][38][39]. The remaining articles (N = 11) did not include a conceptualization of VBHC [40][41][42][43][44][45][46][47][48][49][50].…”

Prudent healthcare in practice: integration of audiology services into primary care

“…Patient-reported outcome measures (PROMs) and patient-reported experience measures are increasingly Open access being used in routine practice throughout NHS Wales as a means of service evaluation. 12 This short report solely focused on recorded clinical outcomes as there are currently no validated PROMs for PC audiology services. Having a validated PROM for PC audiology services would enable patients to participate in the evaluation of this service in line with value-based healthcare principles.…”

Using feedback tools to enhance the quality and experience of care

“…In addition to a focus on what makes SAINTs easier to use and implement, their experience stresses the importance of (i) technology serving patients and (ii) engaging them and their clinicians in the co-production of better care. The section concludes with a paper [23] that stretches the system-level view in another direction as it summarizes the first steps of developing and implementing an electronic platform to collect PROMs and patient-reported experience measures (PREMs) from all secondary care patients across Wales, UK. The processes involved to reach the launch of a fully integrated national electronic data collection platform (in 2016 including over 30 measures) are presented and accompanied with lessons learned including a map of future research and implementation goals.…”