- Fewer than two in ten hospitals regularly use patient-reported outcomes and a similar number of hospital lack the health IT necessary for capturing this data, according to a recent Health Catalyst survey.
Of the 100 clinical and administrative executives responded to the online survey, a mere 18 percent relied on patient-reported outcomes as an important factor in informing clinical decision-making. Close to three-quarters of hospital representatives noting limited or rare use of this patient-generated data (72%) reported plans to incorporate measures tied to patient-reported outcomes within the next one to three years.
According to the International Consortium for Health Outcomes Measurement, patient-reported outcomes range from patient's physical symptoms to quality of life, yet these forms of patient-generated data have yet to find a strong foothold in evidence-based medicine.
"But for most of medicine, the question is no longer whether someone will survive, but how their life will be after treatment," ICHOM's Caleb Stowell, MD, said in a public statement accompanying the published results.
The organization has already identified standard sets 20 conditions and is currently working to promote their adoption by provider organizations.
Use cases for patient-reported outcomes at leading healthcare institutions such as Partners HealthCare and its treatment of coronary artery disease, demonstrate that this data plays a significant role in predictive modeling and intervention activities.
Of hospitals using patient-reported outcomes, their application to tracking chronic and patient recovery from surgery were the most common use cases, 59 percent and 58 percent, respectively. Rounding out the list of PRO use cases were mental health (27%) and cancer symptom tracking (22%).
So what is keeping hospitals from making use of patient-reported outcomes? Several barriers emerged from respondent feedback:
- Time and/or money (36%)
- Incorporation into clinical workflows (26%)
- Technology (15%)
- Organization resistance to change (10%)
- Lack of leadership support (4%)
The findings are troubling considering plans at the Centers for Medicare & Medicaid Services (CMS) to use patient-reported outcomes as a quality measure under the Merit-based Incentive Payment Program.
"Patient-reported outcomes are critical to enabling healthcare's evolution away from focusing on the volume of services delivered to the value created for patients," said Paul Horstmeier, Senior Vice President of Health Catalyst. "Their use promises seismic changes not only in the way providers are paid, but how they measure success, how patients choose their doctors, and most importantly how clinical outcomes are improved. Yet with few exceptions our nation's hospitals are unprepared for the shift and need help managing this new priority within the ever-shifting field of time-intensive regulatory requirements."
The CMS regulation in question, the propose rule for the Quality Payment Program which includes MIPS and Alternative Payment Models, makes clear the value of patient-reported data to improving care quality.
In regards to the Advancing Care Information performance category under MIPS, the federal agency offered a rationale for including patient-generated data as a measure of provider quality relative to patient engagement:
These are measures that reflect the potential to improve patient-centered care and the quality of care delivered to patients. They emphasize the importance of collecting patient-reported data and the ability to impact care at the individual patient level, as well as the population level. These are measures of organizational structures or processes that foster both the inclusion of persons and family members as active members of the health care team and collaborative partnerships with health care providers and provider organizations or can be measures of patient-reported experiences and outcomes that reflect greater involvement of patients and families in decision making, self-care, activation, and understanding of their health condition and its effective management.
And CMS isn't the only federal agency with plans for improving patient engagement by included patient-generated data into provider workflows.
In the Office of the National Coordinator for Health Information Technology Shared Nationwide Interoperability Roadmap, the federal agency laid out its plan for including patient-generated data as a means of tracking patient outcomes.
"Moving forward, the health IT ecosystem needs to put greater focus on (1) incorporating patient-generated health data across health IT products and services, and (2) ensuring the availability of tools for individuals to use a broad range of longitudinal electronic health information to manage their health and make more informed health-related decisions," ONC stated.
If healthcare organizations are searching for incentives in order to make better use of patient-report outcomes, they will not have to wait too long for a financial one.