Amid the growing use of quality measures, patient-reported outcomes should not be overlooked as a potential tool to improve clinical care, according to an article published Monday in Harvard Business Review.
Patient-reported outcomes, or PROs, are a patient's own accounting of symptoms, functional status and quality of life. Increasingly, governments and international organizations are making commitments to make PROs an essential component of measuring quality. For this reason, it may be helpful for clinicians to have a grasp on how PROs can be used to improve care.
Here's how three physicians are using PROs in their practices, as described in Harvard Business Review.
1. Shehzad Niazi, MD, a psychiatrist and internist with Mayo Clinic Jacksonville (Fla.), created a PRO questionnaire to measure patient depression and anxiety. The questionnaire assesses high-priority concerns such as depression, anxiety and pain, in addition to symptoms such as sleep, appetite and ability to concentrate. The information gathered through the questionnaire is used to inform patient visits and has resulted in an average reduction of 15 minutes per patient evaluation, freeing up time for physicians. Mayo has already implemented features of the program to other areas in the system.
2. James Willig, MD, an associate professor and infectious disease specialist with the University of Alabama at Birmingham, uses an electronic PRO survey to measure symptoms like depression, anxiety and suicidal ideation among HIV patients. Dr. Willig launched the survey to stimulate conversations often avoided by both patients and providers in HIV clinics due to the stigma associated with HIV infection. The surveys are used to trigger a member of the clinic's psychiatry team to join patient consultations for support when appropriate.
3. John Spertus, MD, a cardiologist at Saint Luke's Mid America Heart Institute in Kansas City, Mo., and his colleagues use quality-of-life PRO information gathered from patients, as well as data on outcomes for heart failure and stroke compiled in clinical trials. This information is used to counsel patients and their families on expected results of care, inform treatment decisions and reduce patient anxiety. Since the program was implemented in 2002, it has resulted in changes in patient behaviors, which have subsequently contributed to a 45 percent reduction in adverse outcomes among heart failure patients.
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