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Feasibility of a Tablet Computer System to Collect Patient-reported Symptom Severity in Patients Undergoing
Jeffrey Bruckel1, Neil Wagle, Cashel O'Brien
1From the *Massachusetts General Hospital, Edward P. Lawrence Center for Quality and Safety, Boston, MA; †University of Rochester Medical Center, Division of Cardiovascular Disease, Rochester, NY; ‡Brigham and Women's Hospital, Division of General Medicine and Primary Care, Boston, MA; §Harvard Medical School; ‖Partners Healthcare System, Boston, MA; and ¶Massachusetts General Hospital, Corrigan-Minehan Heart Center, Boston, MA.
Insights
Implementing patient-reported outcome measures (PROMs) in routine care for chronic stable angina is feasible. This model captures symptom severity, enhancing quality infrastructure for percutaneous coronary intervention patients.
Area of Science:
- Cardiology
- Health Informatics
- Quality Improvement
Background:
- Percutaneous coronary intervention (PCI) is a primary revascularization method for chronic stable angina, mainly for symptom relief.
- PCI does not improve survival or reduce major adverse cardiovascular events in this population.
- Patient-reported outcome measures (PROMs) for symptoms like chest pain and dyspnea are valid but underutilized in routine care.
Purpose of the Study:
- To present a feasible model for integrating PROMs into routine clinical care for patients undergoing PCI.
- To demonstrate the technical feasibility of capturing patient-reported symptom severity in a real-world setting.
Main Methods:
- A tablet-based software platform was developed and funded by Partners Health System to collect PROMs.
- Implementation occurred in a catheterization laboratory, assessing patients with the SAQ-7, Rose dyspnea scale, PHQ-2, and PROMIS-10.
- A phased approach included pre-procedure measurement, clinical data presentation, and email-based follow-up.
Main Results:
- Successfully captured PROM data from 474 patients, representing 53.5% of outpatient visits.
- Key success factors included strong leadership support, user-friendly interfaces, interpretable measures, and clinical relevance.
Conclusions:
- Routine capture of patient-reported symptom severity via PROMs is technically feasible in clinical practice.
- Sharing this implementation model can help others avoid pitfalls and accelerate nationwide adoption.
- Expansion of PROM programs can strengthen healthcare quality infrastructure.
Background:
Percutaneous coronary intervention is the most commonly performed revascularization modality for chronic stable angina, but does not improve survival or reduce major adverse cardiovascular event. Percutaneous coronary intervention in this population is performed primarily for symptomatic benefit; therefore, symptom reduction is an important marker of quality. Patient-reported outcome measures (PROMs) have been developed for chest pain and dyspnea which are valid and responsive to treatment; however, they are not widely used in routine care. We present a model for use of PROMs in routine care.
Methods:
Partners Health System funded a tablet computer software platform to collect PROMs and include them in the medical record. We implemented this platform in the catheterization laboratory at Massachusetts General Hospital, targeting patients presenting for coronary angiography. Patients are assessed using the SAQ-7, the Rose dyspnea scale, the PHQ-2, and the PROMIS-10. We used a phased implementation, with the final program including preprocedure measurement, presentation of data to clinical providers, and follow up using an email platform.
Results:
We successfully captured measures from 474 patients, 53.5% of outpatient visits. Key success factors included high-level leadership support and resources, a user-friendly interface for patients and staff, easily interpretable measures, and clinical relevance.
Conclusions:
We have demonstrated that routine capture of patient-reported symptom severity is technically feasible in a real-world care environment. We share our experiences to provide others with a model for similar programs, and to accelerate implementation nationwide by helping others avoid pitfalls. We believe expansion of similar programs nationally may lead to more robust quality infrastructure.
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