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Is the Promise of PROMs Being Realized? Implementation Experience in a Large Orthopedic Practice
Jeanette Y Ziegenfuss1, Elizabeth S Grossman2, Leif I Solberg2
1Center for Evaluation & Survey Research, HealthPartners Institute, Minneapolis, MN.
Summary
Patient-reported outcome measures (PROMs) show high patient response rates but low clinical use in orthopedics. Integrating PROMs into electronic health records requires further strategies to overcome barriers and enhance care team adoption.
Area of Science:
- Health Services Research
- Clinical Informatics
- Orthopedic Surgery
Background:
- Patient-reported outcome measures (PROMs) are increasingly utilized for research and quality assessment.
- PROMs hold significant potential for enhancing patient-centered care through aggregate reporting and clinical integration.
- Published studies on the actual clinical use of PROMs remain limited.
Purpose of the Study:
- To describe the implementation and utilization of PROMs within a Midwestern multispecialty medical group's orthopedic practice.
- To track the rate of PROMs use by care teams after their integration into the electronic health record (EHR).
- To identify barriers hindering the integration of PROMs into routine clinical care.
Main Methods:
- A case study approach was employed in an orthopedic practice setting.
- Patient PROMs data were collected for total knee and hip surgery patients.
- Care team access and utilization of PROMs data within the EHR were monitored over time.
Main Results:
- High patient response rates for PROMs surveys were achieved: 68% at baseline, 58% at 3 months, and 55% at 12 months post-surgery.
- Despite high patient engagement, care teams accessed PROMs data in fewer than 1% of clinical encounters.
- Departmental leadership support and EHR availability did not translate to significant clinical use.
Conclusions:
- Availability of PROMs in the EHR, coupled with high patient response rates, is insufficient to drive clinical integration.
- Additional research and interventions are necessary to identify and address barriers to PROMs utilization by care teams.
- Strategies to enhance the adoption of PROMs into clinical practice are needed to realize their full potential in patient-centered care.
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