Department of Medical Social Science, Northwestern University, Chicago, Illinois, United States.
Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, United States.
Appl Clin Inform. 2021 Oct;12(5):979-983. doi: 10.1055/s-0041-1736464. Epub 2021 Oct 20.
There is an increasing body of literature advocating for the collection of patient-reported outcomes (PROs) in clinical care. Unfortunately, there are many barriers to integrating PRO measures, particularly computer adaptive tests (CATs), within electronic health records (EHRs), thereby limiting access to advances in PRO measures in clinical care settings.
To address this obstacle, we created and evaluated a software integration of an Application Programming Interface (API) service for administering and scoring Patient-Reported Outcomes Measurement Information System (PROMIS) measures with the EHR system.
We created a RESTful API and evaluated the technical feasibility and impact on clinical workflow at three academic medical centers.
Collaborative teams (i.e., clinical, information technology [IT] and administrative staff) performed these integration efforts addressing issues such as software integration as well as impact on clinical workflow. All centers considered their implementation successful based on the high rate of completed PROMIS assessments (between January 2016 and January 2021) and minimal workflow disruptions.
These case studies demonstrate not only the feasibility but also the pathway for the integration of PROMIS CATs into the EHR and routine clinical care. All sites utilized diverse teams with support and commitment from institutional leadership, initial implementation in a single clinic, a process for monitoring and optimization, and use of custom software to minimize staff burden and error.
越来越多的文献提倡在临床护理中收集患者报告的结果（PROs）。不幸的是，将 PRO 测量，特别是计算机自适应测试（CAT）整合到电子健康记录（EHR）中存在许多障碍，从而限制了在临床护理环境中使用 PRO 测量的进展。
为了解决这一障碍，我们创建并评估了一种应用程序编程接口（API）服务的软件集成，用于通过电子病历系统管理和评分患者报告的结果测量信息系统（PROMIS）测量。
我们创建了一个 RESTful API，并在三个学术医疗中心评估了其技术可行性和对临床工作流程的影响。
协作团队（即临床、信息技术[IT]和行政人员）进行了这些集成工作，解决了软件集成以及对临床工作流程的影响等问题。所有中心都认为他们的实施是成功的，因为 PROMIS 评估的完成率很高（2016 年 1 月至 2021 年 1 月之间），并且对工作流程的干扰最小。
这些案例研究不仅展示了将 PROMIS CAT 集成到 EHR 和常规临床护理中的可行性，还展示了其实现途径。所有站点都利用了多元化的团队，得到了机构领导层的支持和承诺，最初在单个诊所实施，有一个监测和优化的过程，并使用定制软件来最小化员工负担和错误。
