Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD, 20857, USA.
The Joint Commission, 701 Pennsylvania Ave NW, Suite 700, Washington, DC, 20004, USA.
Qual Life Res. 2019 Jun;28(6):1575-1583. doi: 10.1007/s11136-019-02112-0. Epub 2019 Jan 25.
The effective use of patient-reported outcomes (PROs) can play a critical role in improving health care delivery and patient experience with care. However, PROs are not widely collected and used in clinical practice. This study aims to understand current opportunities and challenges with the use of PROs and the potential for health information technology (IT) to advance their use.
The Agency for Healthcare Research and Quality held two technical expert panel (TEP) meetings to discuss the current use of PROs, challenges, and opportunities in implementation, and how health IT can be leveraged to support effective PRO use in clinical practice. Results were synthesized to identify major themes and takeaways based on different stages of PRO data utilization.
Findings from the TEP meetings indicated varying degrees of PRO usage in ambulatory care settings. Practices often lack a business case to collect PROs. Primary care physicians face more challenges than specialists in selecting appropriate PRO measures due to extensive variation in their patient populations. Providers also need training to use PRO data for shared decision making and population health management. Potential research areas to address PRO implementation challenges include measures harmonization, implementation process and workflow, electronic data collection and integration, and user-friendly data displays.
Opportunities exist during different stages of PRO implementation to advance the use of PROs in clinical practice. Health IT can be utilized to address challenges in data collection, integration, and visualization to make PRO data accessible and understandable to patients and providers.
患者报告结局(PROs)的有效利用可以在改善医疗保健服务提供和患者对护理的体验方面发挥关键作用。然而,PROs 在临床实践中并未广泛收集和使用。本研究旨在了解 PROs 使用的当前机会和挑战,以及健康信息技术(IT)在推进其使用方面的潜力。
美国医疗保健研究与质量署(AHRQ)举行了两次技术专家小组(TEP)会议,讨论 PROs 的当前使用情况、实施中的挑战和机遇,以及健康 IT 如何支持在临床实践中有效使用 PROs。根据 PRO 数据利用的不同阶段,对结果进行综合分析,以确定主要主题和要点。
TEP 会议的研究结果表明,在门诊护理环境中,PRO 的使用程度各不相同。实践中常常缺乏收集 PROs 的商业案例。初级保健医生比专科医生面临更大的挑战,因为他们的患者群体差异很大,难以选择合适的 PRO 措施。提供者还需要接受培训,以便使用 PRO 数据进行共同决策和人群健康管理。解决 PRO 实施挑战的潜在研究领域包括措施协调、实施过程和工作流程、电子数据收集和整合,以及用户友好的数据显示。
在 PRO 实施的不同阶段都存在机会,可以在临床实践中推进 PROs 的使用。健康 IT 可以用于解决数据收集、整合和可视化方面的挑战,使 PRO 数据对患者和提供者都具有可及性和可理解性。