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NWU Project for Patient-Reported Outcomes, EHR Integration

The project will integrate a patient-reported outcomes survey tool with EHRs from nine university hospitals.

By Sara Heath

- A consortium of university hospitals led by Northwestern University has received a $6.3 million grant for patient-reported outcomes and EHR integration, according to a recent press release.

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The grant, awarded by the National Center for Advancing Translational Sciences (NCATS) of the National Institute of Health (NIH), will allow clinicians to collect patient-generated health data in the EHR, ideally improving clinical care and research.

The project will employ the Patient Reported Outcomes Measurement Information System (PROMIS), a surveying tool that adapts to a patient’s unique data and answers. The EHR Access to Seamless Integration of PROMIS (EASI-PRO) project will work to transfer the data collected in PROMIS into each university hospital’s EHR.

The PROMIS survey will include questions about a patient’s physical, mental, and social health. The answers provided in these surveys will help providers deliver higher quality clinical care by catering to all of a patient’s needs. According to leaders from Northwestern University, clinical progress through patient-reported outcomes will improve clinical care and research.

“We are very excited to see this multi-institutional project take off,” said Dr. Donald Lloyd-Jones, director of the Northwestern University Clinical and Translational Sciences (NUCATS) Institute. “This approach to direct, efficient acquisition and integration of patient-reported information represents the future of patient care and medical research, and this project paves the way to that future.”

Presently, PROMIS is connected to Northwestern University’s EHR. Project leaders are also working on connecting PROMIS to Epic Systems and Cerner EHRs. Because Epic Systems and Cerner are two of the largest EHR vendors, this will enable even more physicians to integrate patient-reported outcomes into their patient EHRs.

Northwestern’s progress with PROMIS makes project leaders confident about the road ahead.

“Our experience integrating the PROMIS tools into the EHR at Northwestern has convinced us that tight workflow integration of PROs into the clinical workflow brings many benefits to both quality and clinical research projects,” said Justin Starren, director of the Center for Data Science and Informatics at Northwestern University Feinberg School of Medicine and principal investigator of EASI-PRO.

Other universities participating in the project are the University of Chicago, University of Illinois at Chicago, University of Alabama at Birmingham, University of Kentucky, University of Florida, University of Utah, Harvard Catalyst CTS, and Southern California CTSI.

Successfully integrating patient-reported outcomes is a vital project right now. According to an August Health Catalyst survey, using patient-reported outcomes is currently lagging.

Fewer than two in ten hospitals use patient reported outcomes, while an equal number lack the technology to collect this data.

Only 18 percent of the 100 respondents said they use patient-reported outcomes to inform clinical decisions, while 72 percent reported rare or limited use of patient-reported outcomes.

Respondents cited several barriers to using patient-reported outcomes, with time and money proving to be the biggest obstacle with 36 percent reporting such. Twenty-six percent of respondents said incorporation into clinical workflows was the largest barrier, followed by 15 percent citing technology, ten percent citing organization resistance to change, and four percent citing lack of leadership support.

According to leaders from Health Catalyst, the slow growth of patient-reported outcomes use is concerning.

"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," Health Catalyst Senior Vice President Paul Horstmeier said in a press release. "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.”

Going forward, healthcare providers may want to consider bolstering their efforts integrating patient-reported outcomes into the EHR and their clinical workflows. Not only does this data have potential to improve patient care and research, but federal policies such as Stage 3 Meaningful Use and the Merit-based Incentive Payment System include key protocol for utilizing this data.

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