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Developing an Implementation Strategy for Systematic Measurement of Patient-Reported Outcomes at an Academic Health
Justin M Bachmann1, David R Posch, Gerald B Hickson
1assistant professor of medicine, biomedical informatics, and health policy and medical director for patient-reported outcomes measurement, Vanderbilt University Medical Center, Nashville, Tennessee executive vice president for population health, Vanderbilt University Medical Center, and executive director, Vanderbilt Health Affiliated Network professor of pediatrics and senior vice president of quality, safety, and risk prevention, Vanderbilt University Medical Center deputy CEO, chief health system officer, and senior associate dean for clinical affairs, Vanderbilt University Medical Center professor of medicine and director, Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center professor of medicine, executive vice president for public health and healthcare, and senior associate dean for population health sciences, Vanderbilt University Medical Center and director, geriatric research, education, and clinical center, VA Tennessee Valley Healthcare System; and professor of biomedical informatics and medicine and chief strategy officer, Vanderbilt University Medical Center.
Integrating patient-reported outcome measures (PROMs) into clinical care is complex. A phased strategy involving leadership engagement, needs assessment, and technology adaptation is crucial for successful enterprise-level implementation.
Area of Science:
- Health Services Research
- Clinical Informatics
- Patient-Centered Care
Background:
- Patient-reported outcome measures (PROMs) are valuable tools in research and clinical practice.
- Integrating PROMs into routine care requires a structured approach.
- Academic health centers face unique challenges in implementing new clinical workflows.
Purpose of the Study:
- To develop and implement a strategy for integrating PROMs into routine clinical care at an academic health center.
- To identify facilitators and barriers to PROM implementation.
- To adapt technology for seamless PROM data capture within the electronic health record.
Main Methods:
- A three-phase implementation strategy: exploratory, preparatory, and implementation.
- Leadership engagement and an inventory of existing PROM efforts.
- Pilot site selection, needs assessments, and technology platform adaptation.
Main Results:
- An inventory identified 87 PROM efforts, with 47 using validated measures (62% research, 21% clinical care, 17% quality).
- Three pilot sites were selected based on identified facilitators.
- A technology platform was adapted for EHR integration and pilot implementation began.
Conclusions:
- Integrating PROMs into routine clinical practice is a complex, multi-faceted process.
- Successful integration necessitates enterprise-level change management strategies.
- A phased approach, including technology adaptation and stakeholder engagement, is essential.
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