Language concordance in the digital collection of patient-reported outcome measures

To describe a health system's experience administering patient-reported outcome measures (PROMs) to patients with a non-English preferred language (NEPL).

All PROMs within the Epic EHR were translated into 6 non-English languages: Spanish, Portuguese, Arabic, Russian, Haitian Creole, and Chinese. Starting in quarter 2 of 2022 (Q2-2022), PROMs were administered in patients' preferred languages via the patient portal or tablets in clinic. We tracked language concordance, defined as the proportion of PROMs completed in patients' preferred languages, after implementation.

From Q1-2022 to Q3-2024, 2 657 469 completed PROMs were included for analysis. Patients with English as their preferred language completed PROMs in English 99.9% of the time. Patients with an NEPL increasingly completed PROMs in their preferred language to a maximum of 47.2% of the time, with differences observed by mode: 33.9% and 58.1% of PROMs completed in the patient portal and in clinic, respectively, were language concordant.

Although multilingual, electronic health record (EHR)-integrated digital tools can improve language concordance for PROMs, complex EHR structures and processes limit uptake and hinder equitable access to high-quality patient-centered care.