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Patient-Reported Outcomes Measures Collection Method by Timeframe: Different Strategies for Different Times
Bryan O Ren1, Qi Zhu2, Tae Kim Mhsa2
1University of Michigan, Department of Orthopaedic Surgery, 1500 East Medical Center Drive, Ann Arbor, MI, 48109.
Background:
Registries are attempting to collect patient-reported outcomes measures (PROMs), and the Centers for Medicare and Medicaid Services (CMS) requires their reporting. The purpose of this study was to evaluate the collection method and response rates of PROMs in a regional arthroplasty registry, with the goal of providing strategies for improving collection.
Methods:
This was a retrospective review of primary total joint arthroplasties between July 1, 2021, and June 30, 2023. Preoperative, early postoperative, and one-year postoperative Hip disability and Osteoarthritis Outcome Score Joint Replacement (HOOS JR), Knee injury and Osteoarthritis Outcome Score Joint Replacement (KOOS JR), and Patient-Reported Outcome Measurement Information System (PROMIS-10) collection rates and methods were obtained. A total of 18,602 (out of 71,672) cases met inclusion criteria of completing a preoperative, early postoperative, and one-year postoperative HOOS/KOOS JR and PROMIS-10 survey. Independent samples t-tests and Chi-square tests were performed.
Results:
Completion of all three surveys was more likely in women, never smokers, those who underwent surgery at hospitals or outpatient departments, and had lower American Society of Anesthesiologists classification, social deprivation, and shorter hospital stays. Preoperative surveys were completed by manual entry 49%, file-based acquisition (FBA) 37%, email link 10%, and clinic module 4% of the time. Early postoperative surveys were completed by manual entry 33%, FBA 35%, email link 29%, and clinic module 3% of the time. The one-year postoperative surveys were completed by manual entry 22%, FBA 34%, email link 43%, and clinic module 1% of the time.
Conclusion:
As patients get further from surgery, it is more difficult to obtain PROMs in person, and most are collected remotely. The FBA remains stable regardless of time from surgery. Only 29% of matched cases were able to complete PROMS collection by CMS standards. Strategies to improve PROMs collection should be tailored to patients and timeframe.