Rotenstein Lisa S, Agarwal Ankit, O'Neil Kelly, Kelly Andrea, Keaty Maureen, Whitehouse Colleen, Kalinowski Barbara, Orio Peter F, Wagle Neil, Martin Neil E
Harvard Medical School, Boston, MA, USA.
Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, USA.
J Am Med Inform Assoc. 2017 Sep 1;24(5):964-968. doi: 10.1093/jamia/ocx009.
Patient reported outcomes (PROs) are reports of health conditions that come directly from patients. Use of PROs has been associated with improved patient outcomes, enhanced quality of life, and reduced end-of-life spending. Yet there are still outstanding questions regarding the process of implementing PRO collection in routine practice. In this article, we describe the experience of selecting and implementing PROs in a multisite, multidisease academic medical center-based radiation oncology practice and demonstrate that such large-scale rollout is feasible. We establish that PROs can be implemented with minimal to no workflow delays, are generally seen as valuable by clinicians, and can enhance patient-doctor communication. We additionally detail the challenges involved in selecting clinically relevant PRO questionnaires and the centrality of physician buy-in, easy data access, and clear workflows to successful implementation.
患者报告结局（PROs）是直接来自患者的健康状况报告。使用PROs与改善患者结局、提高生活质量和减少临终支出相关。然而，在常规实践中实施PRO收集过程仍存在一些悬而未决的问题。在本文中，我们描述了在一个多地点、多疾病的学术医疗中心的放射肿瘤学实践中选择和实施PROs的经验，并证明这种大规模推广是可行的。我们确定，PROs可以在最小化工作流程延迟甚至无延迟的情况下实施，临床医生普遍认为其有价值，并且可以加强医患沟通。我们还详细说明了选择临床相关PRO问卷所涉及的挑战，以及医生认可、便捷的数据访问和清晰的工作流程对成功实施的核心作用。
