FORCE-TJR Scientific Director Lead Author on PROMs Implementation Framework Article
Dr. Patricia Franklin, FORCE-TJR and QI-FORCE Senior Scientific Director, along with other leaders in the field, has published a framework for collecting and using PRO data in a learning healthcare system. This work was funded by the Agency for Healthcare Research and Quality through Academy Health’s Electronic Data Methods forum. We’ve summarized the 6 key steps for success here and show how QI-FORCE can support them all.
Step 1: Why PROMs? PROMs collection programs often require significant organizational investment. Make sure you have aligned key stakeholders on the goals of the effort before you start.
A successful PROMs program provides value for a wide range of stakeholders in your organization. For example, PROMs can support quality improvement initiatives, payer mandates, population health research, and shared decision making. When designing your collection program, it is important to think about which of these stakeholder needs it will support and how.
The QI-FORCE system supports all of these goals. Our measures satisfy CJR and MIPS quality reporting requirements, our streamlined data collection system includes individual patient reports to support shared decision making, and our flexible, interactive dashboards support quality improvement and population management analyses.
Step 2: Who? Defining your patient population.
Different patient groups experience unique symptoms and will need to be assessed with different tools. Therefore, it’s important to decide which patient groups you will focus on first. Orthopedics is a great place to start as it typically focuses on high volume, elective surgeries.
QI-FORCE supports PROM collection for hip, knee, and shoulder replacements, as well as lumbar spine surgery.
Step 3: When, Where?
Many people think that PRO measurement is as simple as implementing an IT system to collect survey data from patients. But successful PRO collection is rarely that simple. Organizations achieve the highest survey completion rates with a combined approach that allows patients to complete surveys both in-clinic and at home. This requires both a flexible IT system and streamlined clinic workflows.
QI-FORCE provides a web-based system that captures surveys from patients at clinic or at home, giving providers the most flexibility with data capture. We also offer guidance on integrating PROM collection within your clinic workflows.
Step 4: What?
There are often a variety of PROMs to choose from. You should consider factors such as cost, length, ease of completion and clinical relevance when making a selection.
QI-FORCE has done this work for you. We’ve selected industry standard PROMs that meet the above considerations in English, Spanish and Portuguese.
Step 5: How? Getting down to the details.
In addition to thinking about who, where and what, it is also important to consider how patients will complete the surveys. Some patient populations prefer completing surveys by pen and paper or over the phone. In the future, patients will complete surveys using smartphone apps.
QI-FORCE supports survey completion through the web, paper and phone. Web-based surveys can be accessed by a computer or tablet.
To achieve high survey response rates, you will need a system that tracks completed surveys and send reminders when necessary.
QI-FORCE includes a survey tracking and reminder system.
Finally, you will want to think about how this data will be incorporated into the clinical record.
Your QI-FORCE data is returned back to you for inclusion in the patient record.
Step 6: Informing Practice. Reaping value from your efforts.
The greatest value of PROM collection is achieved when this data is used to inform best practices via predictive analytics, quality improvement initiatives, or population health analyses. These analyses generally require the ability to analyze trends in the data over time and compare risk-adjusted outcomes to external benchmarks.
QI-FORCE memberships include risk-adjusted outcome reports that benchmark your outcomes against our proprietary nationally representative registry consisting of records from more than 30,000 patients.