Patient-reported outcomes (PROs) – patients’ own assessments of their condition and quality of life – have traditionally not been incorporated into day-to-day medical care, but rather, have been limited to clinical research. A new study published in Health Affairs looks at the growing push to include PROs in routine care.
“The provision of patient-centered care requires a healthcare environment that fosters engagement between patients and their healthcare team,” the study notes. “One way to encourage patient-centered care is to incorporate patient-reported outcomes into clinical settings.” The study goes on to say that collecting PROs in routine care (which traditionally has relied more on medical exams and tests) is the only way to ensure that information is captured that only the patient can provide. In addition to quality of life and patient condition, PROs can include symptoms, functioning, preferences and healthcare goals.
PROs have begun to “play a role in successful shared decision making, which can enhance the safe and effective delivery of healthcare,” according to the study. A Washington Post story about the study reports that some medical facilities are beginning to make policy changes that incorporate PROs into clinical care. For example, a recent pilot program mandated by the Centers for Medicare & Medicaid Services (CMMS) reimburses health providers for PROs they collect regarding knee and hip replacement surgeries and follow-up care.
The piece goes on to note that a UMass professor of orthopedics and physical rehabilitation incorporated the CMMS template into a federal program that “implemented PROs for knee and hip replacements in more than 150 surgeons’ offices in 22 states.” Patients’ assessments of their pain (including severity of pain before and after surgery), function and other experiences were included.
Health tracking smartphone apps are another example of how PROs are woven into routine care. These apps allow everyone on a patient’s healthcare team to access information ranging from the medication the person is taking and the last time their drug regimen was changed to their allergies. Patients and health providers can see this data in real time, making it easier to track patient progress.
“Arthritis Power” (www.arthritispower.org), a patient-powered research network formed by CreakyJoints and rheumatology researchers at the University of Alabama, lets people living with arthritis and related conditions track their symptoms, treatments, medications, and health data with their iPhone or Android (via app) and their computer. Designed for patients by patients, Arthritis Power tracks PROs to help researchers understand how people with arthritis respond to different treatments over time. It also helps patients better understand changes in their condition, and work with their doctor to make treatment decisions.
Ultimately, greater focus on PROs will empower patients, while effectively using patient data to improve outcomes. Read more about PROs here.