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Implementation of a patient-reported outcome measure based digital journey and automation tool: A feasibility study
Diana Castro Paupério1, Filipe Freitas Pinto1, Ana Dionísio1
1From the Departamento de Ciências Médicas, Universidade de Aveiro, Aveiro (DP, SG, JFM), Unidade Local de Saúde de Gaia e Espinho (DP, HC, SG, JFM), knok Healthcare, Ltd, Matosinhos, Portugal (AD), Faculdade de Medicina da Universidade do Porto, Porto, Portugal (FFP), Hospital Moriah, São Paulo, Brazil (TC), University of Zurich, Zurich (DRS), Institute for Medical Education, University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland, Centre for Health Technology and Services Research, Faculty of Medicine, RISE-Health, University of Porto, Porto, Portugal, Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (JBE), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal (JFM).
Background:
Patient blood management (PBM) has been shown to improve patient outcomes and optimise resource use. However, the systematic collection and analysis of patient-reported outcome measures (PROMs) remains challenging, limiting their integration into PBM pathways and into value-based healthcare (VBHC) strategies.
Objectives:
This study aims to evaluate the feasibility and adherence to an automated VBHC digital tool for PROMs collection in a population of cardiac surgical patients, within the context of PBM implementation.
Design:
A single-centre, pragmatic, prospective feasibility study.
Setting:
A tertiary Portuguese hospital considering data from 1 March to 6 September 2024. A total of 12 professionals were actively involved in the patient journey design.
Patients:
A total of 221 patients (65.2% men, mean age 66.7 ± 9.9 years) with a scheduled cardiothoracic surgery were included.Main outcome measures: Percentage of planned interactions successfully completed.
Results:
A two-phase digital PROMs journey was implemented in less than 2 months. A total of 638 interactions were completed by 221 patients, resulting in a global completion proportion of 72.1%. 36-Item Short Form Survey Instrument (SF-36) and BPI questionnaires, completed by 77% of patients, results at 90 days compared to results at initial evaluation (SF-36 physical: t = -0.424, P = 0.681; mental: Z = 33.0, P = 1.000; Brief Pain Inventory (BPI) Pain Severity and Interference: Z = 23.0, P = 0.646). The PHQ-9, completed by 76% of patients, identified five severe and nine moderately severe depression cases. Educational content had a 73.9% reading completion proportion across 303 views.
Conclusions:
We showed the feasibility of implementing a digital tool to monitor patient PROMs, along with its adoption by patients and health professionals. This strategy has the potential to contribute to improving healthcare professionals' motivation, access to real-world data, personalised monitoring, and allowing for faster implementation of corrective actions, with an impact on patients' outcomes and costs.