Enhancing Clinicians' Use of Electronic Patient-Reported Outcome Measures in Outpatient Care: Mixed Methods Study

Area of Science:

• Health Services Research
• Clinical Informatics
• Healthcare Management

Background:

• Patient-reported outcome measures (PROMs) are increasingly used in hospital outpatient settings.
• Clinicians' utilization of PROM data for patient care remains suboptimal.
• Limited insight exists into strategies for enhancing PROM data use.

Purpose of the Study:

• To examine clinicians' use of PROM data in value-based outpatient consultations.
• To identify organizational strategies enhancing PROM use in a Dutch university hospital (2020-2023).
• To explore factors driving and constraining PROM use among clinicians in 2023.

Main Methods:

• Integrated data from performance metrics (n=70), hospital documents (n=56), clinician surveys (n=47), and interviews (n=20).
• Utilized the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
• Analyzed strategies using the Expert Recommendations for Implementing Change (ERIC) taxonomy, structured by capability, opportunity, and motivation.

Main Results:

• Clinicians accessed PROM data for only 14% of outpatients in 2023, despite numerous strategies.
• Hospital strategies covered 37% of ERIC strategies, focusing on capability, opportunity, and motivation, but had execution shortcomings.
• Variations in influencing factors were observed among frequent, occasional, and non-users of PROMs.

Conclusions:

• Enhancing clinician PROM use is challenging, requiring more than capability, opportunity, and motivation strategies.
• A shift in clinicians' professional attitudes and practices is necessary for effective PROM integration.
• Hospitals should facilitate genuine clinician engagement with PROMs, considering tailored strategies for different user groups.