by Elizabeth Olson and Jacob Lippa
Globally, there is increased interest from both clinicians and administrators to understand the full potential of patient-reported outcomes. As Dr. Judith Baumhauer of the University of Rochester writes, “PROs [patient reported outcomes] are not a new concept; however, the ability to collect PRO data in real time, and the focus on sharing this information with the patient and using it in clinical decision making is the future.” And indeed, Dr. Baumhauer and her team are giving us a glimpse of what that future looks like.
In her recent New England Journal of Medicine Perspective, Dr. Baumhauer provides examples of the exciting progress that has been made in the measurement program at the University of Rochester. Founded in early 2014, the program is rooted in an advanced integrated system for collecting, visualizing, and sharing PRO data. Information for outcomes including physical functioning, pain, and depression scores has been collected from over 148,000 patients since the program’s inception.
Collection of this information is just the beginning. As anyone with experience implementing outcomes data measurement can attest, measurement alone is insufficient to change clinical practice or affect outcomes. Through her article, we learn how Rochester is using outcomes measurement to take quality improvement projects to a new level – helping clinicians understand their patients’ needs, expectations, and treatment options in a new dimension. Perhaps the most innovative aspect of the program is the use of PROs for predictive modeling, wherein preoperative PROMIS scores are used to forecast the benefits of surgical intervention (or lack thereof) for foot and ankle surgery. Similar analyses have been done for other common procedures within the department, as well, including spine surgery and total joint replacement. The potential for impact is undeniable, as ensuring appropriate use of high-cost and high-volume procedures yields cost-savings as well as improves safety for patients.
Changing clinical practice, as we have alluded to in our previous post on ICHOM Keynote Speaker Peter Tollman, is about more than just common purpose. However, what we may take away from Dr. Baumhauer’s work is that having clear use cases in mind for incorporating PROs into routine clinical care is a key element of a successful implementation program. Supporting this hypothesis are other efforts described by Dr. Baumhauer that are being made in organizations like the NHS and the University of Utah, whose purposes range from guiding clinical conversations to identifying and disseminating best practices within a hospital system.
We are excited to welcome the pioneers of these projects to share their progress, lessons and challenges at the 2017 ICHOM Conference. Dr. Baumhauer will be presenting in morning and afternoon breakout sessions. Please click here for the conference agenda and here to register.