Designing an Electronic Patient-Reported Outcomes Information Infrastructure Supported by the RE-AIM Implementation...

Area of Science:

• Health Informatics
• Clinical Informatics
• Patient-Reported Outcomes

Background:

• Patient-reported outcomes (PROs) offer valuable insights for timely interventions and improved patient quality of life.
• Implementing electronic PROs (ePROs) presents technical and evaluation challenges.
• A robust framework is needed to integrate ePROs into electronic health records (EHRs).

Purpose of the Study:

• To construct a robust EHR-integrated ePRO information infrastructure.
• To found the infrastructure on RE-AIM (reach-effectiveness-adoption-implementation-maintenance) principles.
• To optimize for clinical utility, informatics operations, and implementation evaluation.

Main Methods:

• Utilized Epic Systems EHR to build the MD Anderson Symptom Index Head and Neck Module (MDASI-HN).
• Established RE-AIM metrics to design patient, provider, and facilitator information tools.
• Proposed a dynamic 2-cycle implementation model for continuous adaptation.

Main Results:

• Collected 13,156 patient-submitted ePROs from 3,497 unique head and neck patients (Jan 2021-Jul 2024).
• Achieved an 82% 12-month sustained ePRO compliance rate.
• Demonstrated benefits including integrated clinical data and potential scalability.

Conclusions:

• The developed ePRO framework enhances decision-making through integrated clinical data.
• Formative evaluations were crucial for optimizing ePRO compliance and usage.
• This article provides a roadmap for developing comprehensive, EHR-based ePRO infrastructures.