A web based PROM collection system for monitoring and service evaluation in musculoskeletal patients

Background: Patient reported outcomes (PROMs) have been increasingly on the agenda of a number of European governments. In the UK these have been associated with postoperative collection of patient reported data since April 2009. The move towards centralizing the patient in the care process as well as quantifying outcomes important to the patient have led to calls for widespread use of these instruments by 3rd party payers. There are considerable barriers to implementing routine collection of data using traditional paper based methods. However, digital approaches hold promise in addressing such barriers. This paper will report the development of and results generated using a web based PROM/PREM collection system (CareResponse (CR)) specifically for use in MSK patients attending community based outpatient services. Methods: Care Response was developed as a tool to facilitate the routine collection of PROMs and other questionnaire based information directly from patients. The following components were identified as useful for supporting patients undergoing care and physicians in practice Reducing or removing the need for input from clinical organizations in requesting patients to complete follow up assessments. Maintaining flexibility for clinicians to ask patients to complete questionnaires when clinically indicated for example during a formal case review. Providing patients and clinicians instant access to their completed assessment forms Scoring PROM forms and presenting practitioners results in an easy to interpret graphical format suitable for discussion with patients Enabling clinicians to compare collated results from their patients with anonymized collated results from all users of the system. Thus providing benchmarking against which to judge their service. International Journal of Integrated Care – Volume 14, 01 November – URN:NBN:NL:UI:10-1-116543– http://www.ijic.org/ International Digital Health and Care Congress, The King’s Fund, London, September 10-12 2014. CR accomplishes these goals through the use of a cloud based relational database. Consenting patients are entered using their name, date of birth, and email address. In its routine use in clinical practice CR generates a ‘pre examination’ questionnaire containing questions preselected by the clinical organization. CR can send an email to the patients with a link to its database allowing patients to complete questions on any computing device able to access the internet. Alternatively patients may opt to complete the assessment either on paper (to be keyed in later by organizational staff) or more usually on a tablet while in the waiting area upon initial consultation. Follow up questionnaires can be generated automatically at timed intervals or specifically at time points according to clinical need. Results: At present 159 organisations delivering MSK care in the private sector are using this system. To date 25053 patient records have been collected. Conclusion: A web based approach to collecting PROMs and PREMs has generated large data sets in MSK patients that effectively describe service provision, patient outcomes and experiences. We believe this is a proven and innovative way to provide the data needed to monitor and assess the success and satisfaction of patients receiving health care provision in this and the wider health care sector

Business · Data collection · Medical emergency · Prom · Service (business · Clinical practice guidelines implementation · Delphi Technique in Research · Medicine · Musculoskeletal Disorders and Rehabilitation · Nursing