The problem with Patient-reported outcomes measures (PROMs)

Collecting Patient-reported outcomes measures (PROMs) is a trending topic in healthcare. The main reason we see increasing importance is because PROMs are a critical part of the industry’s shift to a value-based healthcare (VBHC) model. In 2010, Professor Michael Ported made clear why PROMs are essential:

“Value should always be defined around the customer, and in a well-functioning health care system, the creation of value for patients should determine the rewards for all other actors in the system. Since value depends on results, not inputs, value in health care is measured by the outcomes achieved, not the volume of services delivered, and shifting focus from volume to value is a central challenge”

Several studies showed that collecting PROMs in certain conditions like cancer results in an increased overall survival rate, improved quality of life or decreased emergency room visits and hospitalization. Collecting PROMs is feasible, improves clinical outcomes and is valuable to patients and clinicians.

PROMs became a buzzword

But, and yes there is a but. It became a buzzword. In all this fuss, some have forgotten the real reason for collecting PROMs. They are clinically meaningless if it is not used for what it was meant for: improving outcomes that matter for patients. This should be the main incentive for collecting PROMs. It should not be a conference the hospital is attending, it should not be a fancy value-based healthcare population dashboard or it should not be because you want a publication in a top tier research journal. A lot of institutions and healthcare professionals measure just to measure. That’s totally wrong. It’s all about the patient.

There is no point in asking a patient to fill in weekly questionnaires if you are not ready to act upon it. Patients don’t mind filling out questionnaires, as long as we communicate how this data will improve their outcomes and outcomes for patients like them. We must ask ourselves the question: what are we going to do with all this data? A crucial part of collecting PROMs is the ability to take this data and transform it into actionable insights. PROMs should drive actions and decision making. And that is where it often goes wrong. In healthcare, we are often data-rich but intelligence and information poor.

That is where we fall short. We capture so much data, but we only use a small percentage of this data. And it’s normal. Because we have so many data points, no one has the time or energy to look and interpret all of this. Collecting PROMs without a vision, without a purpose or without a use-case is totally useless. Collecting PROMs does not necessarily mean you are embracing value-based healthcare. If you aren’t applying what you measure to improve care pathways and outcomes: stop it. Please. If improving patient outcomes is not your incentive to collect PROMs: once again, stop it. Please.

A shift to key patient-reported outcomes measures

For me, the solution is simple: only collect the outcomes you are willing to act upon. In business, we do the same thing. We measure Key Performance Indicators or KPIs. The word key is important here. We don’t track more than 100 KPIs. We track a maximum of 10 KPIs. That’s it. Keep it simple. These 10 KPI’s help our organization track how well we are doing to meet our objectives. And that’s exactly what we need to do in healthcare. Get rid of all the PROMs we don’t use and start by tracking key patient-reported outcomes measures that matter most to patients.

This is a personal blog. Any views or opinions expressed are my own and do not necessarily represent those of my employer (Awell Health).

Feel free to connect with me on LinkedIn or Twitter. If you have a comment or feedback you can also send a note to rik.renard@hotmail.com

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Passionate about innovation in Healthcare. I work at Awell Health as partnership manager.

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Rik Renard

Rik Renard

Passionate about innovation in Healthcare. I work at Awell Health as partnership manager.

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