Qualitative study of patient-reported outcome data collection among clinicians in dermatology at a single academic...

Patient-reported outcomes (PROs) help dermatologists better understand patient perspectives to facilitate shared medical decision-making. Despite merit-based incentive payment system (MIPS) measure to collect quality of life assessments at least once every 12 months for patients with chronic skin diseases, routine PRO collection remains uncommon in clinical practice. This semi-structured interview study aimed to elicit key preferences, facilitators, and barriers for routine PRO collection in dermatology practices.

Clinicians were recruited from Emory Dermatology, which has implemented routine PRO collection. Verbatim transcripts were coded and analyzed deductively using the Theoretical Domains Framework to generate salient themes. We interviewed nine dermatologists and one advanced practice provider (APP).

Professional roles of all interviewed clinicians aligned with PRO collection. Memory, attention, and decision-making requirements for PRO collection by clinicians were minimized via institutional automation in the electronic health record (EHR). Skills in navigating EHR were needed to retrieve PRO data. Environmental factors affecting PRO collection included patient portal access, IT support for EHR integration, institutional interest in PROs, limited clinician oversight on PRO collection by other staff members, and high patient volume in dermatology clinics. Social support between staff could allow workflow division and maximized opportunities for PRO collection, while clinician perceived patient survey fatigue and skepticism on PRO utility affected PRO collection. This study was limited to clinician perspectives in a single clinic.

Automating PRO collection and utilization in EHR, demonstrating PRO value, establishing institutional support, and streamlining workflow are needed to broadly implement routine PRO data collection.