While physicians may understand the value of PROs, completing PROs, particularly outside of the office visit, is a new paradigm for patients. We learned from over 50,000 patients that patients are willing and able to complete these assessments. However, understanding why PROs are valuable to their care will help motivate them to complete them consistently.

First, clinicians and health systems can distribute invitations to patients that explain the importance of completing PROs in preparation for an office visit. Let patients know that the data they provide helps the clinician understand symptom severity and how symptoms impact their physical and mental health. After initiating treatment, a change in PROs lets clinicians know if the care is improving their health. There is a sample patient message in our Implementation Workbook (link to Implementation Workbook)

Completing PROs may also be useful to patients when preparing for appointments. Our participants repeatedly emphasized these points.

"The survey [PRO] was such an eye opener and a really great thing to go through prior to my appointment! I never really thought about how much my hip pain was impacting my life, but that survey made me take a deep dive into that. It was important to have that understanding going into this appointment.”

Technology can be a barrier, even for motivated patients, to completing PROs. The electronic health record (EHR) requires portal access and passwords and your patients may not understand how to set up or use these features. Other technologies, including apps and text messages, may also be confusing.

We found that when patients understand the value of the PRO data, they are willing to learn new technologies to complete the assessments. Most patients simply request a brief tutorial to introduce new tools to them. Consider having someone in your office explain how to set up or use your preferred collection method and/or provide detailed written instructions that can be used outside of the office.

Additionally, while EHRs are English-centric, PROs are available in many languages. When possible, allow patients to complete the surveys in their first language. Providing support, easy technology, and PROs in the patient’s preferred language enables patients to better complete PROs independently.

Ensuring that patients receive their PRO scores and understand score interpretation will empower them to report PROs and motivate them to complete follow up assessments.

Most patients will benefit by receiving a simple guide to interpretation of the PRO score. For example, offering an interpretation of the number, how the score compares to other patients, and what key tasks and activities may align with the score will help the patient understand the PRO score. Consider including arrows and color-coded (e.g., red-yellow-green) indicators to guide interpretation.

Graphical displays are helpful, but patients will typically require an explanation to fully understand their PRO data. In the A.S.K. study we offered group coaching sessions where we reviewed the PRO data together. We recognize that not all practices will have the resources for that type of support. However, even a written explanation of the PRO report can be helpful. We have included some examples of graphs used in the A.S.K. study along with descriptions that we shared with participants. Patients regularly reported that these explanations were helpful. For example:

“I felt it was very helpful to go over the graphs on the first page [of the report]. I was confused and didn’t understand at all, but now feel much more knowledgeable.”

In summary, returning PRO scores can empower patients, allow them to be more prepared for appointments, and can help clinicians better understand patient priorities, health status, and values. We prepared a handout that patients can use when reviewing PRO scores with questions that they can use to reflect on the data and what they would like to discuss at their next appointment.

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