Patient Reported Outcomes in Clinical Care

Patient-reported outcome measures (PROs, or PROMs) are one of the most efficient tools for quantifying the patient experience. That’s why they’re used across many clinical care settings today. PROMs are helping primary care clinics systematically screen for depression and refer patients to treatment, helping patients capture pain trends between doctor visits, and providing the patient-reported information that helps people choose between surgical options.

At PatientsLikeMe, we’ve seen firsthand the power of PROMs to help patients manage their health and share their status with their doctors and other patients. We’re excited about the power of PROMs to make healthcare more efficient, improve patient engagement, and support better outcomes.

If you’re a clinician with questions about PROMs and how to use them, see our answers below. And if you’re already working to advance the use of patient-reported health data and measures in a clinical setting, we’d love to work with you. Contact us at openscience@patientslikeme.com to learn more about how PatientsLikeMe and its Open Research Exchange can help you develop and use PROMs in your own practice.

How can patient-reported outcome measures (PROMs) help my practice?

In several ways. When implemented consistently, frequently, and between in-office visits, PROMs also document the progression and fluctuation of a disease, allowing clinicians to accurately monitor a patient's health status. They give a quick and accurate read on the patient experience so that office visits are more efficient and effective. PROMs can also help clinicians provide immediate feedback to and educate patients on their own condition.

Do patient reported outcome measures lead to better outcomes?

PROMs lead to greater insight into a patient’s experience and health journey. When tracked over time, these measures can be used to educate the patient on prevention methods, and lead to better clinical care.

How can PROMs help me with quality measurement?

Payors and healthcare organizations are incorporating more patient feedback to manage and engage high-risk populations, and implementing various reimbursement methods and incentives to better target care and engage patients. PROMs are a key tool for helping you see if you are attaining better outcomes. They provide useful information to optimize clinical decision making and can be used to uncover and address any blind spots.

How are practices managing PROs and how can I fit them into my current workflow?

In a clinical setting, PROMs can be completed on paper, on the phone or online through a patient portal, tablet or in-office computer. Some practices are using PROMs in between office visits, during office visits and at discharge from a hospital stay. They tend to optimize office visits because they focus discussion on the most important information.

Whose permission do I need to use a PROM?

This varies by measure, institution or practice. The license terms of each measure or instrument control where it can be used. Many PROMs allow usage at no cost in clinical settings, but others restrict commercial use.

ORE simplifies this by making all instruments developed on the ORE platform available to be used and extended at no cost, under the Creative Commons Attribution 3.0 United States license.

Where would I encounter a PROM today?

In any number of ways. For example:

  • A patient can use a PROM on their own to see changes in their condition.
  • An individual physician may decide to use a PROM to gather useful clinical information about their patients.
  • A hospital may mandate the use of a PROM, such as the depression rating scale for postpartum women.
  • A payor may request results of a PROM and collect data for reimbursement.

Can I get reimbursed for using a PROM?

While the use of PROMs are increasingly mandated by payors, their use in clinical practice does not specifically increase reimbursement. Institutions, clinicians, policy makers and payors should lobby together to encourage reimbursement for use of PROMs as a best practice.

Meet Dr. Brennan Spiegel, an advocate for the use of PROs in clinical practice, who believes they are "the ultimate measure of what’s working."

Dr. Brennan Spiegel, Director of Health Services Research at Cedars-Sinai and Professor of Medicine and Public Health at UCLA