to patients and hence delivering patient-centred healthcare across the continuum of care. Patient-reported outcome measures (PROMs) will play a central role in measuring the quality of care delivered. The primary aim of health care is treating patients with the least possible side effects whilst achieving the best possible quality of life after treatment. Traditional measures on core services have been based solely on clinical measurements such as mortality and morbidity. These measurements provide necessary and objective indicators of quality of care, but are limited in terms of measuring patient’s quality of life during and after treatment including treatment related side effects and functional disabilities.
PROMs are a measurement of any aspect of a patient’s health status that comes directly from the patient (1). PROMs measure patients’ views of their symptoms, their functional status, and their health related quality of life at a single point in time, and are collected through short, self-completed questionnaires. This health status information provides an indication of the outcomes or quality of care. By comparing a patient’s health at different times, the outcome of the care received can be determined. This measurement of outcome also distinguishing PROMs from patient reported experience measures (PREMs), which focus on aspects of care, such as satisfaction with treatment or patient experienced errors (2).
However, there is limited experience with implementing a system-wide initiative to collect and use patient reported outcomes for quality and value improvement. Results from clinical trials suggest that routine assessment of PROMs – by patient self-reporting of symptoms in the clinic waiting room or between visits via electronic interface – has been shown to be feasible and efficient and to increase patient satisfaction with care (3). It can help guide treatment planning, decision making and improvements in symptom management as well as patients’ overall quality of life (4). Further, sensitive information such as sexual concerns or alcohol use is more likely to be obtained via electronic symptom monitoring and to be more reliable compared with face-to-face reporting (5).
In the past, patient-reported symptom information has not been routinely collected as a part of clinical care, largely as a result of logistic barriers. As we move into an era of interconnected electronic health information, collection and clinical use of patient-reported data should play a prominent role in addressing the needs and concerns of patients. PROMs are where data driven health care and patient centred care intersect.
If you would like more information on PROMs – the role and impact on quality in health care – you can attend the ISQua Pre-Conference Programme on Sunday 13th October 2013. The pre-programme will address important themes: PROMs as well as patient engagement, where focus will be on providing insight into the practice of engaging patients through examples from various systems and levels.
(1) U.S Department of Health and Human Services Food and Drug Administration Guidance for Industry (2009): Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims.
(2) Black, N (2013): Patient reported outcome measures could help transform healthcare. BMJ;346:f167.
(3) Bennett A, Jensen RE, Basch E (2012): Electronic Patient-Reported Outcome System in Oncology Clinical Practice. CA Cancer J Clin. Sep-Oct;62(5):337-47
(4) Valderas JM, Kotzeva A, Espallargues M, Guyatt G, Ferrans CE, Halyard MY, et al. (2008): The impact of measuring patient-reported outcomes in clinical practice: a systematic review of the literature. Qual Life Res;17:179-93.
(5) Dupont A, Wheeler J, Herndon JE II, et alm (2009): Use of tablet personal computers for sensitive patient-reported information. J Support Oncol 7:91-97