Every innovation in healthcare is striving for the same thing – to improve patient outcomes. But how do you actually measure a patients outcome?
Healthcare professionals love objective measures. They provide a way to track and monitor things. So historically a patients ‘outcome’ was assessed using measures like survival, complication rates of surgery, revision rates of surgery, strength measures, radiology findings, blood tests etc. These are obviously all important but they can miss the bigger picture and arguably the most important thing – which is does the patient actually feel better and function better? This is particularly important in the field of MSK medicine where a getting patient to return to work, sport or daily activities is the aim of the game.
Clearly the best way to know if a patient is getting better is to ask them.
Talking to patients is something we do routinely as part of clinical care, but a Patient Reported Outcome Measure (PROM) is a questionnaire that can help provide an objective way track this.
They are validated through clinical research and hundreds exist, covering all aspects of medicine and health. They are used in research routinely, but are perhaps underutilised in a clinical setting.
One reason for this is that using PROMs in day to clinical practice is challenging. They are typically paper based. Which means not only does the clinician need to think about doing it, but they have to decide which tool to use, find it or print it out, get the patient to complete it, manually score it and then enter the result somewhere. The barriers are high and for most practitioners this results in PROMs not being particularly useable – they do not enhance patient care.
But if PROMs were easy to collect and facilitated the patient-clinician interaction then things would be a different story. In the current era of the quantifiable self, people inherently want to track aspects of their life. Whether that is steps with their activity-tracker, runs and rides with their sport-apps, sleep, food, weight, blood pressure etc. In our experience patients with injuries or conditions that affect their daily living are no different. Using PROMs helps patients and treating clinicians to understand how a condition affects them and how that progresses over time. They can improve patient engagement. Ultimately if used well they can help the treating clinician by providing a snapshot of how that patient is managing with pain and function at a particular time.
If patients are knowledgeable about how their condition affects them, engaged in management and develop trust in their treating practitioners then that in itself can lead to better outcomes.
From a practitioners perspective PROMs can save time, improve the patient-clinican relationship and ultimately improve patient care. They can also be used to measure outcomes to different treatment protocols and hence improve a clinicians understanding of the treatments they offer.
Here at MyScoreIt we are trying to break down the main barriers to using PROMs in daily practice – ease of use and an understanding of how and when to use them.