Patient-Reported Outcome Measures (PROMs) are invaluable tools in assessing the effectiveness of medical interventions. They offer insights into the patient’s perspective on their health, quality of life, and treatment outcomes. However, capturing these outcomes consistently and accurately presents challenges. This paper outlines effective techniques and strategies to enhance the capture rate of PROMs, drawing from evidence-based practices and emerging trends.

Education

Patient Education

The foundation of effective PROMs capture begins with patient education. The most significant impact a care provider can have is by personally communicating the importance and purpose of PROMs to their patients. When patients understand that their feedback directly influences their care and treatment outcomes, they are more likely to participate actively. Clear communication from the surgeon fosters trust and compliance, as patients become aware that their input is crucial for their own care.

To support this, healthcare providers should distribute educational materials, such as pamphlets and posters, that explain the value of PROMs. These materials can reinforce the care provider’s message and provide patients with a tangible reminder of their importance.

Staff Education

Educating the entire care team, including nurses, administrative staff, and physical therapists, is equally important. When the staff understands why PROMs are collected and how they impact patient care, they are more likely to encourage patient participation and assist in the process. Training sessions and ongoing education can help embed the importance of PROMs into the daily workflow of the healthcare team.

Multiple Modalities for Data Collection

Relying on a single method for collecting PROMs is insufficient in today’s diverse and technology driven environment. A multi-modal approach ensures that all patients, regardless of their technological proficiency or preferences, can participate.

Remote Reach

Patients should be able to complete PROMs remotely using their computers or smartphones. To accommodate varying levels of technological comfort, healthcare providers should offer multiple remote delivery methods, such as email, SMS, and messaging applications like WhatsApp and LINE. Automating the delivery of these messages can streamline the process, while also allowing for ad hoc requests when necessary.

Phone Proxy

For patients who are less comfortable with technology, phone proxy collection, where staff or volunteers call patients to complete PROMs over the phone using standardized call scripts, can be effective.

In-Person Collection

In clinics, providing tablets or iPads in waiting rooms allows patients to complete their PROMs while they wait for their appointments, which increases capture rates and enhances patient satisfaction by productively occupying their time in the waiting room. Additionally, healthcare providers can implement other on-premises technologies, such as QR codes that patients can scan with their own devices to complete PROMs. This method is convenient for patients, and it benefits the clinic by reducing the need to manage hardware, lowering costs, and minimizing IT frustrations, thereby further encouraging participation.

Additionally, providing paper forms during in-person appointments ensures that patients who prefer traditional methods or are experiencing technical issues can still participate.

Reducing Barriers

To maximize participation, it’s crucial to reduce barriers that might discourage patients from
completing PROMs.

Language Accessibility

Offering PROMs in multiple languages allows patients to choose their preferred language, making the process more inclusive and accessible to underserved populations. This approach helps ensure that language is not a barrier to participation.

Simplified Access

Avoid requiring patients to install software, create usernames, or remember passwords to complete their surveys. Simplified access, with easy-to-follow steps and minimal on-screen clutter, can help patients navigate the process independently. Reducing the cognitive load associated with completing PROMs is essential in preventing survey fatigue.

Survey Fatigue

Be mindful of the frequency and number of questions asked. Overloading patients with too many surveys or questions can lead to survey fatigue, reducing their willingness to participate in future surveys. Balancing the need for data with the patient’s capacity to provide it is key to sustaining engagement.

Enhancing Patient Engagement

Engaging patients throughout their care journey is critical to maintaining their participation in
PROMs.

Holistic Communication

When reaching out to patients for PROMs, provide additional value by including other relevant information. For instance, alongside a PROMs request, send emails or messages that prepare patients for surgery, manage their expectations, or offer post-operative care instructions. Providing videos of exercises or words of encouragement can enhance engagement by showing patients that they receive tangible benefits from the communication.

Feedback on PROMs

Offering feedback on PROMs results can further engage patients. Providing them with summaries of their scores, recovery curves, and comparisons with peers can create a sense of involvement in their care. This personalized feedback reinforces the importance of their participation and helps patients understand the impact of their responses on their treatment plan.

Feedback Loops

Creating meaningful feedback loops is essential for sustaining patient engagement and ensuring that PROMs are used effectively in clinical decision-making.

Graphical Summaries

Provide patients with easy-to-read graphical summaries of their recovery progress over time. These visuals can help patients see the trajectory of their recovery and understand how their scores relate to their overall health.

Benchmarking

Allow patients to compare their progress with peers who have undergone the same procedure. By matching peers based on diagnosis, age, and sex, patients can gain insights into their recovery relative to others, which can motivate continued participation and adherence to care plans.

Dialogue Creation

Using PROMs to initiate conversations with patients can deepen the patient-provider relationship. By discussing the patient’s responses and how they influence care decisions, providers can demonstrate the value of PROMs and encourage patients to continue participating.

Relevance and Incentives

While there are clear incentives for healthcare providers to collect PROMs, such as improved reimbursement rates, research opportunities, and marketing data, it is crucial to highlight the
relevance of PROMs to patient care.

Clinical Relevance

The clinical relevance of PROMs needs to be emphasized in all communication with stakeholders. PROMs are not just a bureaucratic requirement; they offer valuable insights into a patient’s care journey, enabling providers to make informed decisions. Research and education efforts should focus on demonstrating how PROMs can lead to meaningful changes in treatment and outcomes.

Patient-Centered Incentives

To fully engage patients, it’s important to convey how PROMs benefit them directly. For example, PROMs can help identify issues early, tailor treatment plans, and improve overall care. Educating patients about these benefits can enhance their motivation to participate.

Conclusion

Successfully capturing PROMs requires a multifaceted approach that goes beyond simply asking patients to fill out surveys. By integrating education, leveraging multiple data collection modalities, reducing barriers, enhancing patient engagement, and creating feedback loops, healthcare providers can significantly improve PROMs capture rates. However, further work is needed to ensure the clinical relevance of PROMs and to continue educating all stakeholders on their importance.

Further Work

Future research and education should focus on understanding the clinical relevance of specific PROMs questions and their impact on patient care. Additionally, efforts should be made to educate healthcare providers on what constitutes meaningful change in PROMs scores, helping them use this information effectively in clinical decision-making.