Patient-reported outcomes for performance measurement: Multi-institution challenges.

Abstract

211 Background: Patient-reported outcomes (PROs) are self-reported measures of a patient’s health or healthcare experience. PRO utilization is driven by the movement toward patient-centered care and emerging evidence which suggests patients (pts) more involved in their care experience better outcomes. The infrastructure to capture PROs is evolving and PROs are now used for performance measurement (PM). PRO-PMs assess the quality of healthcare for improvement and/or accountability; but implementation is challenging. Success of PRO-PM requires identification of pts, ongoing data collection and data aggregation across institutions. The Alliance of Dedicated Cancer Centers (ADCC) identified challenges of PRO use for PM. Methods: The validated tool, Expanded Prostate Cancer Index Composite, evaluating pt function and bother from treatment (trt), administered to new localized prostate pts at three independent cancer centers was retrospectively collected. Surveys administered before and after trt measured change from trt. Results: Institutions implementing PROs following local standards resulted in a high degree of variation. The aggregated data presented challenges in identifying eligible pt populations who received surveys before and after trt within a timeframe. We identified a pragmatic and meaningful pt population and survey implementation window. Pts were stratified by center and trt modality for analysis. Conclusions: The aggregation of dissimilar data sources led to the identification of institution implementation and data capture differences, however, the ADCC identified variation for PRO measure development. Clear guidance, policies and procedures are essential to ensure adequate homogeneity and reduced variability, to assure meaningful PM and reduce confounding by institution. [Table: see text]