Our Approach to Collecting PROs

For all of their potential value, PROs have proven to be challenging to collect, especially in busy clinical settings. For this reason, we developed this guide to PRO implementation to support clinical care. The guidelines address PRO capture either in clinic or from patient homes between visits. These PRO collection guidelines are based on successful PRO collection initiatives with tens of thousands of patients and in dozens of clinical sites. Through this experience, we identified best practices that clinicians and implementation researchers can use to successfully reach PRO collection rates that accurately reflect all patients and can meet reporting requirements while serving clinician use during patient visits.

Our approach to implementing PROs is pragmatic and considers the resources available for the PRO collection effort. Our process augments the clinical workflows you have in place and results in collection rates that meet regulatory and research standards so that your data accurately reflect your patient population and clinical practice.

  • Patients are the best source of information about their health status. Patients can provide health-related information including current physical status, social determinants influencing health, health behaviors, family history, and environmental exposures. Clinicians who collect patient reported outcome measures (PROs) find the information informs treatment decisions by amplifying the voice of the patient. Because PROs use standardized questions, they offer consistent assessment of health over time providing effective, reliable information about changes.
    You likely have identified a reason for implementing PROs. The most common uses we encounter include:

    ● Clinicians want to use PROs in clinical care to assess patient symptoms and inform treatment decisions.

    • PRO scores establish the symptom baseline to evaluate treatment response.

    • Reviewing PROs with patients can facilitate shared decision-making
      conversations about treatment options.

    ● Annual PRO monitoring can help identify changes in physical or emotional health status to meet annual wellness visit mandates.

    ● Health systems use PROs in aggregate as a component of their quality program, tracking population-level data and reporting outcomes to regulatory agencies or payers.

  • A team that includes key partners, including patients, will help you confirm the ways you collect and use PROs. This team will play important roles in PRO implementation and monitoring. Key team members include practice administrators, clinicians, office staff, information technology and patients.

  • After identifying an initial reason for implementing PROs, it is valuable to review the potential uses of PROs with a team of partners. Team members will help refine the “who, when, and why” questions that determine whether the primary reason to collect PROs is to serve individual patient care, system quality improvement activities, external reporting, or all three reasons.

  • The summary table in our PRO Implementation Workbook can further assist the team in identifying the specific value proposition for PROs in your organization. The table outlines several roles for PRO data when used by different partners or in varied settings. While PRO use may be consistent across partners, other reasons vary in importance. For example, patient and clinician benefits include defining the need for treatment, shared decision making, evaluating provider performance, or assessing treatment effectiveness while payers or regulators may use the aggregate.