PROMs data infrequently accessed by members of clinical care, study suggests

                           Even when patient-reported outcome measures (PROMs) are successfully incorporated into electronic health records (EHRs), these patient-centered data are infrequently accessed by members of clinical care teams, suggests a study in the November/December issue of American Journal of Medical Quality (AJMQ), official journal of the American College of Medical Quality (ACMQ). The journal is published in the Lippincott portfolio by Wolters Kluwer.

                           At one large orthopedic practice, care teams accessed PROMs data for less than 1% of visits by patients undergoing total knee or hip replacement surgery, according to the report by Jeanette Y. Ziegenfuss, PhD, of HealthPartners Institute, Minneapolis, and colleagues. They write, "Making PROMs available for care team review in the EHR...is not enough to encourage integration of PROMs into clinical care for patients."

                                          

                           A key focus of efforts to measure healthcare quality, PROMs are designed to capture data on outcomes important from the patient's perspective – for example, daily functioning, quality of life, and experience of care. Data from PROMs have mainly been used for public reporting of system-wide outcomes or quality improvement initiatives. Few studies have evaluated whether and how PROMs are being used to inform everyday patient care.

                         As part of a larger project at a Midwestern health network, the study orthopedic department made an investment to integrate PROMs into the electronic health records (EHRs). Starting in 2017, the clinic began collecting PROMs data on all patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA), including assessments of joint function, general health and functioning, and patient satisfaction.

                        How was this information used at the point of care? To find out, Dr. Ziegenfuss and colleagues analyzed how often the PROMs data included in the EHR were accessed by orthopedic surgeons and other members of the care team for patients undergoing TKA or THA over a 15-month period in 2019-20.

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