Use of Patient-Reported Outcomes Advances with New NQF Roadmap
A need exists for meaningful quality measures emphasizing patient-reported outcomes. In a fractured health system, we must also address the operational necessity to reduce the burden of data collection while streamlining the quality measurement process.
Healthcare providers and payors sounded these concerns in the past decade. Amid the pandemic of the last two years, two other vital issues crystalized, underscoring the concerns:
- The need to measure and impact the delivery of equitable care
- Myriad opportunities presented by the accelerated expansion of virtual, community, and home-based care
Another building block now in place: Next-generation measurement of patient-reported outcomes
The National Quality Forum (NQF) released a technical guidance report from the “Building a Roadmap from Patient-Reported Outcome Measures to Patient-Reported Outcome Performance Measures” initiative in November 2021.
The NQF Roadmap was funded by the Centers for Medicare and Medicaid Services (CMS) and sets the guidance on how to develop digital patient-reported outcome and performance measures (PROMs and PRO-PM) central to elevating the patient’s voice and accountability programs. This secures one more building block in the foundation for new quality measurement.
The Roadmap is a critical patient-reported outcomes resource
Regarding healthcare quality and outcomes, the gaps between documented care visits are like a puzzle short some pieces. For example, a provider may have a general picture of a patient’s health. Still, the view lacks essential insight like type, frequency, and severity of symptoms, the impact of the condition on daily life, and patient attitudes.
Used in conjunction with medical assessments and tests, patient-reported data gives providers additional relevant data and context. Several methods exist for handling patient-reported outcomes data, although seamless and accurate collection methods that are convenient and easy for to use are still emerging.
This underscores the value of the roadmap.
The patient-reported outcomes quality measurement process
Integrating the patient’s voice in healthcare quality measurement is essential to delivering value-based care. The lack of NQF-endorsed patient-reported outcome performance measures limits payers and providers’ ability to integrate these meaningful measures into new clinical care and payment models.
The burden of data collection
Providers directly influence the improvement of the clinical care process and payers increasingly incentivize providers towards new models of care. These efforts provide a needed, if incremental, improvement. But if we are to make significant inroads with improving quality, patient outcomes and lowering the costs to serve a given population, the bigger opportunity requires systems integration.
The new roadmap is a critical resource that will guide health tech developers through all four phases of digital patient-reported outcome and performance measure development to test the reliability, validity, and feasibility of products and platforms. Digital patient-reported measures can integrate into multiple systems and decrease burden by collecting once and efficiently re-using to improve care.
The clinical value of patient-reported outcomes measures (PROMs)
Patient-reported outcomes measures (PROMs) measure how a patient's health changes over time. Evaluated at intervals (e.g., every three months or before and six months following a procedure), PROMs are essential to understanding how a patient responds to treatment. At the population level, the information helps build evidence about which care plans work and which don’t and, most importantly, for whom.
In clinical care, studies demonstrate the value of patient-reported outcomes measures for predicting outcomes from treatment and identifying patients at risk for complications and unplanned care. PROMs have also shown their value in improving patient and provider satisfaction, enhancing relationships between physicians and their patients, and enabling shared decision-making.
PROMs can improve health outcomes for all
Today, patient-reported outcomes measures remain underutilized. Widespread use will only become routine when tooled for digital data collection. The adoption of interoperability standards and coding schemes will allow for integration with EHRs and care management systems.
Use of the roadmap to guide development of digital PROMs moves us in the right direction of focusing on patient outcomes, elevating the patient voice in quality measurement, and reducing burden. Incorporating patient-generated data and reported outcomes is fundamental to effectively monitor the health of patients receiving home and remote care, especially those with multiple, chronic conditions. Digital collection can enrich the data necessary for clinical decision-making.
Widespread, easily administered, and digitally collected patient-reported outcomes (PROs) will advance equity, strengthening the care experience for patients and providers and improving health outcomes for all.