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3 Ways Patient-Reported Outcomes Inform Patient-Centered Care
Article

3 Ways Patient-Reported Outcomes Inform Patient-Centered Care

The healthcare system is evolving to care delivery models that put patient health outcomes at the center of care. As it transitions, providers and payers are looking for strategies to succeed in this new environment. Patient-reported outcomes, or PROs, are a valuable resource in building these patient-centered care systems.
   
If your system has been collecting patient-reported outcomes but isn’t yet leveraging the data, learn more about the specific ways providers can use PROs to improve clinical care. 

What are patient-reported outcomes?

The Centers for Medicare & Medicaid Services explains patient-reported outcomes as “any report of the status of a patient’s health condition or health behavior that comes directly from the patient, without interpretation of the patient’s response by a clinician or anyone else.” Said plainly, patient-reported outcomes, or PROs, are data supplied by the patients themselves, unfiltered through a medical professional in any way.

What kind of health data do patient-reported outcomes include?

Patient-reported outcomes can include health-related data surrounding

  • Quality of life, such as functional status
  • Symptoms, such as pain and fatigue
  • Behaviors, such as smoking, diet, and exercise

What are patient-reported outcomes measures?

The specific tools used to measure PROs are sometimes called patient-reported outcomes measures (PROMs). These validated tools are becoming more and more available and condition-specific. 

Two common examples are

  • PHQ-9  to assess the severity of depression
  • HOOS, JR and KOOS, JR  surveys to assess hip and knee function after joint replacement

How patient-reported outcomes reflect patient experience and satisfaction

PROs are related to both patient experience and patient satisfaction measures, but there are subtle differences. A patient can be satisfied with their physician and the care itself while experiencing poor outcomes. This peculiarity makes it increasingly valuable to measure outcomes from the patient perspective. The information offers another data point for providers as they analyze patient care, determine treatment options, and engage in shared decision making.

While providers or payers do not currently use PROs on a population health level or for quality measurement, that is likely to change. Forward-looking organizations that master these tools now will certainly benefit as the value-based models mature. 

Three ways to use patient-reported outcomes in patient-centered care strategies

PROs are useful for both patients and providers. On an individual level, providers can use PROs to assess patients before and during treatment. At the institutional level, PROs can help a provider improve the quality of health outcomes and care. 

Baseline patient status and goals

Before treatment begins, document a patient’s baseline status and goals for later comparison and build a personalized care plan
While PROs stand for patient-reported outcomes, the tools don’t always need to be administered after the fact. Providers can use many of the forms and surveys as a baseline for later comparison. For certain conditions, PROs are most useful to providers when used over time.

For example, a patient referred to a specialist for knee replacement surgery could be asked to fill out a survey (such as the KOOS, JR) before their first appointment. The survey captures information about the patient’s current pain and function level. After the surgery, the patient fills out the same survey. The provider looks for improvement in the patient-reported outcomes over time. Ideally, the patient reports less pain and the ability to comfortably perform previously impossible actions.

Patient-reported outcomes can also help providers craft personalized care plans, a key pillar of patient-centered care. By capturing a patient’s personal health goals and values at the start through PRO tools, physicians can clarify precisely what the patient hopes to achieve with treatment. 

In the knee replacement example above, it benefits the physician to know which aspect of knee function most bothers the patient so they can offer guidance to maximize function in that area. By clarifying the patient’s priorities (whether as modest as gardening comfortably or as ambitious as running a marathon), PROs can assist providers in developing personalized care plans that patients are most likely to follow.

Using PROs as part of shared decision making and designing patient-centered treatment plans leads to more realization of the patient goals, higher patient and provider satisfaction, and enhanced physician–patient relationships.  

Refine the patient care plan

At the point of patient care, PROs can spur a clinician to examine the treatment they are providing a patient and make changes to improve care. For example, a patient with depression takes the PHQ-9 survey upon beginning therapy with antidepressant medication and then again six weeks later. 

If their score doesn’t change in that time, the provider can reassess and discuss the care plan with the patient considering the PROs. Perhaps the patient needs more time for the medication to work. Or perhaps they need other treatment modalities, such as talk therapy or a different medication. The data from patient-reported outcomes can factor into improved clinical decision making. 

New studies show potential for patient-reported outcomes and functional status reports to provide indicators of upcoming care needs. Monitoring PROs could help identify needs for early intervention and avoid unplanned care or unplanned visits to the emergency department.  

Examine clinic performance

PROs can also be a valuable source of information for the hospital or health system to improve its operation as part of quality improvement and optimization of patient outcomes. PRO data can inspire discussion and data inquiries leading to insights that drive better outcomes. 

PRO data provides a different lens through which to view healthcare quality, value, and outcomes apart from patient experience or patient satisfaction scores. This complementary view has its own distinct value when optimizing patient outcomes and experience. 

A key component of value-based care is effectively segmenting data into distinct subpopulations to determine the best intervention at the right time for each individual. Health systems can use PRO data from within their operation to learn what works for specific patient populations they serve. Continuous refinement using these observations plays a critical role in quality improvement.

Patient-reported outcomes are a key resource for providers

Patient-reported outcomes are data reported by the patient in their own words, unfiltered through clinical staff interpretation. While PROs can be related to patient experience scores, they are a distinct and valuable resource.

PROs can be used as part of the shared decision-making process to determine, evaluate, and adjust treatment plans. They can also play a key role in improving healthcare and healthcare delivery when aggregated at the institutional level.

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