Impetus of US hospital leaders to invest in patient-reported outcome measures (PROMs): a qualitative study

Abstract

ObjectivesThough hospital leaders across the USA have invested significant resources in collection of patient-reported outcome measures (PROMs), there are very limited data on the impetus for hospital leadership to establish PROM programmes. In this qualitative study, we identify the drivers and motivators of PROM collection among hospital leaders in the USA.DesignExploratory qualitative study.SettingThirty-seven hospital leaders representing seven different institutions with successful PROMs programs across twenty US states.MethodsSemistructured interviews conducted with hospital leaders. Transcripts were analysed using thematic analysis.ResultsLeaders strongly believe that collecting PROMs is the ‘right thing to do’ and that the culture of the institution plays an important role in enabling PROMs. The study participants often believe that their institutions deliver superior care and that PROMs can be used to demonstrate the value of their services to payors and patients. Direct financial incentives are relatively weak motivators for collection of PROMs. Most hospital leaders have reservations about using PROMs in their current state as a meaningful performance metric.ConclusionThese findings suggest that hospital leaders feel a strong moral imperative to collect PROMs, which is also supported by the culture of their institution. Although PROMs are used in negotiations with payors, direct financial return on investment is not a strong driver for the collection of PROMs. Understanding why leaders of major healthcare institutions invest in PROMs is critical to understanding the role that PROMs play in the US healthcare system.

Health Care Value in Plastic Surgery Practice

“…[24][25][26][27][28] Although health information technology shifts the burden of data collection to patients, investments in infrastructure, data teams, and adaptations to clinic workflow are still necessary. In addition to real-time monitoring by individual departments, 26 these incentives will likely also require top-down investment and cultural shifts at the hospital system level, 29 alongside pressure from payers for outcome collection. Although private practices may face greater challenges with the administrative overhead associated with PRO collection, gathering these data may help them better market their services or anticipate the incorporation of PROs as quality metrics in payment policies.…”

Operationalizing PROMs at the Musculoskeletal Practice and Policy Levels

“…For patients and orthopaedic surgeons and their teams to reap the benefits of PROMs, they must be collected routinely-for both surgical and nonsurgical patients-across as many patients as possible as part of standard clinical care. Although many hospital leaders recognize the need for this to occur and feel a strong moral imperative to do so, 10 success in this area has remained elusive. In fact, according to a recent survey conducted by the American Alliance of Orthopaedic Executives, only 35% of orthopaedic practices were collecting PROMs.…”