Patient-reported outcomes necessary but difficult to obtain

Healthcare ratings are all the buzz, as are the methodologies for gathering data. But what if patients had a greater say in both?

That's the concept behind what are known as patient-reported outcome measures (PROMs), according to a blog post at NEJM Catalyst by Neil W. Wagle, M.D., a medical director with the Partners HealthCare system in Boston.

A PROM uses validated questionnaires to determine how the patient actually feels, and would help to capture quality being delivered throughout the current spectrum of care, according to Wagle.

When implemented properly, they can capture quality of life issues of most concern to patients. But the results, he notes, vary significantly depending on treatment choices, institutions, and providers.

Prior studies have strongly suggested that providers obtain patient-reported data because it could be used to optimize their overall health, in particular capturing crucial information such as patient diets and adherence to their medication. Moreover, such self-reported data in specific areas—such as diagnoses for multiple sclerosis—tends to mirror overall claims data, suggesting that patients don't overreport their experiences in a way that could lead to muddied information.

However, there are a variety of obstacles to deploying PROMs, according to Wagle. For example, the data needs to be submitted and gathered electronically, requiring technology platforms many hospitals and healthcare systems lack.

Moreover, hospital staff buy-in is also critical, and may be unlikely given their current workload.

“Even if the technology works perfectly, patients, clinic staff, and clinicians—busy people already—must work together to make PROMs a reality,” Wagle wrote. “Convincing them that the small effort is worthwhile is half the battle.”