Using patient-reported outcomes to drive patientcentered care

With health care becoming more patient-centered and outcome and valuedriven, providers and payers need to be able to measure, report and improve outcomes that are meaningful to patients. These outcomes can only be provided by the patients, and thus systems are needed to be able to capture patient-reported outcomes (PROs) and allow both patients and providers to use the data both on an individual patient level as well as on a population level. Information technology is already playing a central role in collecting, applying analytics to and reporting the PRO data. This includes collection of patient-generated data onsite through tablets/kiosks and offsite through patient portals and internet, smartphone applications and telephones through interactive voice-response applications. Reporting of analyzed data through electronic medical records will allow clinicians to discuss the information with patients. For such a system to work, several challenges need to be overcome, such as attaining high response rates for data reporting from patients, integrating PROs into the provider-patient encounters, allowing for real-time data collection and reporting, enabling data reporting by proxy (family members/caretakers) and addressing methodological issues such as case-mix adjustments. Although PROs are new to the clinical landscape, some successful case studies exist and need to be studied as more local attempts are made and policy starts to emerge. In this chapter I will describe three case studies of successful PRO implementation and will attempt to emphasize lessons learned from each, emphasizing the important role that health information technology plays.