More Health Care Leaders Are Going to PROMs, Are You?
Posted by Lauren Keeran on 2019-04-26
A very recent article in Physician Leaders* reported that patient-reported outcomes measures (PROMs) “help physicians optimize treatment”. This benefit, among many others PROMs offer, is motivating more physicians and administrative leaders to collect and use this important data source to improve and grow their practices. PROMs are not new, but as healthcare moves more rapidly toward value-based payment and treatment environments, they provide the articulation of outcomes that is necessary to credibly demonstrate “Value” performance to patients, payers and health care partners.
Increasingly, leading practices are recognizing PROMs as assets and monetizing them to improve and grow their business in many ways. As Troy Simonson, CEO of Twin Cities Orthopedics (TCO), a large independent specialty practice of 39 clinics and 115 physicians across the Twin Cities metro area and western Wisconsin says in a recent blog, “Collecting and using our patient-created data has been a very worthwhile enterprise for us.” Troy’s article credits the use of their data with a substantial increase in new patient visits, meaningful escalation in the number of direct employer relationships, significant growth in the number of commercial payer bundles they provide, and greater success in negotiating co-management agreements.
PRO data can also help improve practice performance in several ways. With the collected PROM data, each provider’s patient outcomes can be viewed for absolute and comparative performance against the practice overall and against external benchmarks to credibly establish absolute and relative performance. This can be done for individual physicians and/or the entire organization for all procedures for which PROMs are collected (e.g., total knee reconstruction, knee arthroscopy, total/partial hip replacement). This data can also be used to identify best practices and provide trustworthy data for discussions with physicians needing to improve their patient outcomes.
PROMs can also be used to deliver and convey value to patients. Mary Barton, MD, MPP and vice president of performance measurement at the National Committee for Quality insurance advises that, “… patients often relish the opportunity to relay their symptoms or function level.” PROMs data offers the perfect opportunity for patients to do this and for physicians to collaborate meaningfully with their patients in shared decision making and procedure outcomes discussions. Collecting PROMs signals to patients that physicians care about their quality of life and functionality, and plan to bring a data-informed approach to their care and treatment. Pre-treatment discussions with data at hand can encourage a sense of collaboration and affords the opportunity to clearly set outcomes expectations based upon a valid understanding of the patient’s status. Post-treatment discussions with the patients’ own data at hand can demonstrate the improved level of functionality obtained and provide patients with additional information they can share with friends and family, an impactful practice growth strategy.
And, the good news is that using patients’ PROMs data in discussions does not take any longer than that typically dedicated to a procedure visit. In a study conducted by the University of Austin Medical school, it was found that “there was no significant difference in the duration of the in-office consultation … between the shared decision-making group and the control group, and surgeons reported greater satisfaction with consultations under the shared decision-making program.”
Further, through the advantage of machine learning, completion of PROMs instruments can be even easier and less demanding on patients and practice staff. Computer Adaptive Testing (CAT) technology has been proven to meaningfully reduce the time and effort required by patients to complete the surveys. OBERD has developed CAT technology as a clinical practice tool for outcome measure collection. The OBERD-CAT technology has been applied successfully to all of the other PROMs recommended in 2018 for use by the American Academy of Orthopedic Surgeons (AAOS), as well as the Oxford Hip and Knee surgery surveys (OHS and OKS, respectively), and has been demonstrated to result in notably higher completion rates while retaining score accuracy.
Returning to practice growth, in a previous article I cited the positive correlation between PROMs outcomes and patients’ satisfaction with their provider. This favorable situation can lead to patients providing positive reviews for the practice website and on Google and third-party physician choice sites such as Healthgrades and Vitals. This broad reach of favorable opinions also increases the likelihood of new patients selecting your practice as their needs arise.
As Dr. Neil Wagle of Devoted Health in Massachusetts observed in the referenced article, “PROMs provide a quantification of the outcomes that matter most to patients.” PROMs can also provide benefits that matter most to the practice.
So, join other leading practices going to the PROMs and enhance your practice’s performance and success.
*As Health Care Moves to Value, More Leaders Going to PROMs, Susan Kreimer, Physician Leadership, April 12, 2019.