This action brief from the Consumer-Purchaser Alliance describes how patient-reported outcomes (PROs) are increasingly used to measure health care quality performance. While patient experience of care is one of the triple aims, we rarely, if ever, ask patients to report whether the care they received made a difference in their lives.
PROs refer to the changes in an individual’s physical and/or mental health status, including their ability to perform normal household functions and job duties unhampered by disability, resulting from medical treatments and procedures. They are typically measured using a standardized patient survey instrument, such as exist for asthma, depression, back pain, and many other conditions. These data are not collected in clinical practice on a wide scale in the United States. For patients, PRO results can lead to better informed decisions for treatment and selection of providers. For purchasers, PRO reporting could help to identify which providers deliver care that patients find most beneficial.
The action brief calls for the following actions:
- Purchasers should build PROs into new value-based payment models.
- Purchasers should require collection and reporting of PRO performance measures at the physician and hospital levels through accountable care organizations and/or in direct contracting.
- Purchasers should encourage their employees to discuss their interest/need for PRO results with their physicians.
- Purchasers should incorporate PROs into mandatory transparency requirements at the health plan and provider levels.
- Consumers should ask their health plans and providers to give them PRO information.
- Consumers should continue advocating within policy-making bodies for the inclusion of PROs in public accountability and public reporting programs.
- Consumers and purchasers should insist that their providers use PRO surveys that are parsimonious and capture information that is meaningful to the patient.
- Consumers and purchasers should advocate for providers to create electronic patient portals for patients to enter PRO data
- Consumers and purchasers should advocate for wider adoption of measures that already exist and are being used in the field
- Purchasers should urge their plans to help pay for provider collection of PROs and sharing the data to further development of PRO performance measures.
Ignatius Bau 