POWER UP
WITH PROMS
PROMS – AN OVERVIEW
There is an increasing interest in the use of patient reported outcome measures (PROMs) in healthcare delivery. Paucity of resources globally has demanded robust, valid ways of measuring outcomes so that clinical and financial healthcare resources can distributed appropriately
PROMS are standardised validated questionnaires completed by patients to evaluate how they feel about their health status and outcomes.
When used with real time feedback, PROMs data can be harnessed to tailor individual patient care, obtain feedback on clinician performance and benchmark quality of care within and across healthcare organisations.
THE NEED …….
With initiatives like value-based health care and pay for performance, PROMS are being viewed increasingly as a policy driven requirement. Healthcare leaders need evidence based models to successfully deploy PROMs in their organisations to fully leverage their potential.
WHY COLLECT PROMS?
PROMs put the voice of the patient first. They are a key component of value based healthcare.
Benefits for patients
An example of real world benefit has been demonstrated by Basch et al.
Their study outlined the results of an eight-year programme with 766 cancer patients where a real-time PROM enabled patients to report their symptoms and to send alerts to their nurse carer when symptoms were concerning.
The study’s findings are compelling. Basch reports a 10% increase in survival rates for cancer patients from this real-time PROMs approach. That is a stronger impact than most new cancer drugs achieve!
Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Basch, E.M et al. Jul 2017
WHY COLLECT PROMS?
The importance this study highlighted is ‘real time’ feedback triggered by patients through PROMs to nurse specialists that led to counselling, medication change or referral to hospital. This engagement allowed patients to feel in control of their treatment and increased compliance with chemotherapy regimes by 33% - survival rates consequently increased.
The take home message is clear, patient reported outcomes improve quality of healthcare delivered and improve patient compliance and satisfaction rates.
Shared value of PROMs... for clinicians, hospitals, mayors, policy makers
REALISING THE POTENTIAL OF PROMS
Lack of clinician engagement
Lack of real time use
Lack of understanding how PROMs can influence decision making
CHECKLIST FOR A SUCCESSFUL PROMS PROGRAM
1. The design of the program
- Validated
- Patient centered
- Ease of use for patients and frontline clinical workers
- Live data collection and feedback both to patients and clinicians at the point of care
- Easy to access (within the electronic medical record)
- Establish the guiding principles of PROMs collection – asking the right patients the right questions at the right time
- Defining the standards, operations and technical requirements – which PROMs tools to use, collection target rates, workflows of collection and data storage
2. Patient engagement
- Dont be over ambitious, define target collection rates realistically and as organisational experience and patient awareness grows, incremental increases in collection rates can be worked into the program
- Patient education, for buy in is key.
- Build in digital platforms within patient apps for data collection for ease of use.
- Ensure opt in and opt out processes for patient participation
3. Staff engagement
- Use technology to allow staff to focus on patient care rather than spend time collecting the surveys
- Ensure real time availability of PROMs data within the electronic medical records to allow clinicians to make decisions based on data. This will ensure frontline staff buy in as they see real world clinical implications of PROMs data
- Identify champion clinical users to roll out the program. Our experience has shown this is key to successful implementation
- Provide real time alerts to staff based on PROMs data to allow clinical decision making
4. Hospital Leadership
- Set SMART goals for each program and ensure regular reporting at the Executive and Board level against these
- Use PROMs data driven decision making at divisional, departmental and as the program matures individual clinician level to gauge performance and benchmarking
- Ensure top down and bottom up engagement to make this a success
We can help you deliver a high impact PROMs program. Our team is the only provider that has experience of successfully embedding a PROMs program with real time feedback at the point of care in KSA.
SUMMARY
WHAT WE OFFER
Our experience has shown that for PROMs programs to be successfully deployed and embedded in organisations, the following principles are vital
- Engagement and education of frontline clinical staff prior to deployment
- A strong mandate for organisation wide usage from the management rather than small scale, silo based deployment
- A robust preferably digital based platform to collect and view the outcomes
- Testing and refining prior to deployment
- Rigorous feedback loops for evaluation and sharing of learning across the organisation.
If you are mandated to use PROMs we strongly recommend you make them part of your organisational culture and DNA. The benefits are immense from a clinical, operational and financial perspective.
There is large amounts of real world evidence demonstrating that effectively allowing patients to report their health outcomes provide greater patient satisfaction, improves quality of care provided, improves clinical outcomes and improves efficiency within an organisation.
