How the voluntary reporting outcomes can be a clinical differentiator for practices

As healthcare in the United States continues to shift toward a value-based care system, patient-reported outcomes (PROs) are becoming increasingly important to patients, providers, and payers.

For specialty medical practices and clinics, these voluntarily reported outcomes also have the potential to be a clinical differentiator and are giving a competitive advantage to those who fully leverage this data.

Today more than ever, patients have choices when it comes to where they receive care. For hospitals, ambulatory surgery centers (ASCs) and physician practices, being able to quantify the value of care provided is a crucial aspect to improving patient acquisition, especially in a competitive market.

What are patient-reported outcomes and why do they matter?

As defined by the Centers for Medicare & Medicaid Services (CMS), patient-reported outcomes are reports coming directly from patients about their health conditions, or health behavior, without interpretation of the patient’s response by a clinician.

Among the information that patients may typically self-report are:

• General health, including mood
• Quality of life, functional status and ability to complete activities
• Symptoms such a pain or fatigue
• Health behaviors, including smoking, diet and exercise
• Side effects from new medications or treatments

PROs are usually collected with validated questionnaires that are received directly from patients. These questionnaires range from general health surveys to questions about specific issues or treatments.

For example, the Knee Injury and Osteoarthritis Outcome Score (KOOS) measures short and long-term symptoms and function among knee or osteoarthritis patients. KOOS was developed to help providers assess their patient’s own opinions about their knees and potential problems to gain further insight into how symptoms and functions change over time.

From a clinical perspective, PROs help healthcare organizations improve care outcomes and optimize patient experiences. Focusing on quality of life and functional abilities, rather than physiological and medical results, PROs help providers consider patient goals, participate in shared-decision making, and facilitate a more value-based care delivery method. Operationally, PROs directly impact quality ratings, such as those published by CMS and are often used as part of value-based reimbursement ratings.

The ability to capture and properly analyze patient outcomes allows organizations to answer key quality questions such as, “How do our outcomes compare across providers?”; “How do our outcomes compare to other practices?”; and “How and where can we best improve?”” Together, these elements directly impact patient acquisition, patient retention, and provider reputation.

Challenges with patient-reported outcome collection

Despite their clinical and operational value, the use of PROs is not yet as widespread in the United States as it should be, according to The Commonwealth Fund.

Among the reasons often cited as to why PROs are not collected more often are:

• It can be difficult to link PROs to treatments, as factors such as patient compliance and social determinants of health (SDoH) can influence actual outcomes
• Clinicians are not able to bill for time spent fielding outcome surveys
• Collecting enough PRO data to enable analysis requires high levels of compliance
• Providers may lack the training or resources needed to use PRO reports effectively
• Fear of disrupting clinical workflows

The role of patient compliance

To effectively assess quality of care, improve care delivery and conduct research, clinicians need to have a robust database of patient outcomes data. However, generating this database requires patients to participate and provide the required health information. As in most industries, it is difficult to consistently engage the consumer.

With PROs, studies have shown that compliance rates widely vary depending upon the target patient population, modality of administration, and the care setting. For example, one study has shown that among patients who received shoulder arthroplasty, PRO compliance was 72% at baseline, 47% after one year and 33% at the two-year mark.

Achieving high compliance of PROs to achieve differentiation

When it comes to PROs, there is no single solution for practices to maximize compliance and guarantee meaningful results. Instead, providers should seek to consistently address as many of the tactics outlined below to achieve high quality data, engaged patients, and meaningful insights to improve care quality and the patient experience.

• Set clear goals. PROs can be used to measure many things. However, outcomes data is most valuable when the purpose for collection is defined at the start.What insights or data-driven actions do we want to unlock?
• Provide relevant content. As mentioned, it is difficult to engage patients. To increase likelihood of participation, ensure that the information requested is relevant to the individual patient and more importantly where they are in the care journey.
• Use previously validated questions when possible. Using validated questionnaires can reduce the time and resources spent on survey development.
• Avoid questions that may be misinterpreted. When patients can interpret questions in multiple ways, the results can be inconsistent and provide useless data.
• Engage Physicians and Administrators. Compliance rates are frequently shown to be higher when physicians are trained in using PROs and administrators are involved in monitoring collection rates.
• Set expectations at the point of care. Providers that take the time to discuss PROs with their patients unlock the added benefit of higher compliance rates in the future.
• Make PRO collection a part of intake. If PRO questionnaires are outstanding, patients can complete them along with other pre-appointment paperwork.
• Reminders rule. Email reminder messages have a strong impact on patent compliance.
• Keep it simple. Every barrier that a patient encounters to complete a task makes them less likely to do so. Makes your PRO questionnaires as brief as possible and frictionless to access.
• Automate the process. As practice staff are already balancing many administrative tasks, and clinicians rarely have spare time, the process of collecting PROs should be automated when possible to maximize the chance of success. Patient-Reported Outcomes Measure (PROM) platforms can automate collection, measurement, and analysis of patient outcomes data.

Getting it one

While collecting PRO data is essential for achieving successful patient-centered care strategies, it is also critical for positioning medical practices as being true health care partners, that empower patients to take an active role in their care.

In this era of increasing consumer choice, physician practices can utilize PROs to further set themselves apart from the competition and position themselves as preferred care providers in the market.

Matt Gitelis is the founder and CEO of PatientIQ. PatientIQ is cloud-based solution that empowers hospitals, health systems, private practices and industry partners to collect, measure and analyze patient-reported outcomes data to improve clinical and operational performance.