National Implementation of an Electronic Patient-Reported Outcome Measures Program for Joint Replacement Surgery:...

Area of Science:

• Orthopedics
• Health Informatics
• Public Health

Background:

• Global push to collect joint replacement data beyond implants and revisions.
• Patient-reported outcome measures (PROMs) are crucial for patient-centered surgical outcomes.
• Electronic data collection and sharing of PROMs face financial and systemic barriers.

Purpose of the Study:

• Develop and implement an electronic PROMs data capture and reporting system for a national joint replacement registry.
• Identify and overcome barriers to the implementation and uptake of electronic PROMs.
• Provide a cost analysis for establishing and maintaining a nationwide electronic PROMs program.

Main Methods:

• Established governance committees to develop and implement a PROMs pilot program within a national registry (2018-2020).
• Collected preoperative and 6-month postoperative data electronically for hip, knee, or shoulder replacements across 44 Australian hospitals.
• Utilized a scalable online platform with features for multiple user access, patient registration, automated reminders, online consent, and real-time outcome dashboards.

Main Results:

• Registered 10,204 procedures (51.80% of total) during the pilot period.
• Achieved efficient patient registration (20-30 seconds) and data collection (10-12 minutes).
• Dashboard engagement varied by user group, with lower patient and surgeon uptake (12.9% and 45.3%, respectively).
• Established program cost estimated at Aus $7-15 per patient for two PROMs collections.

Conclusions:

• Successful national rollout of an orthopedic PROMs program requires substantial funding and staffing.
• Investment in PROMs collection and reporting can significantly improve healthcare processes.
• Enhancing stakeholder engagement, particularly among patients and surgeons, is vital for the long-term success of national PROMs initiatives.