Health Technologies

Frontiers study explores electronic patient-reported outcomes within routine clinical care – htn

A study has been published in Frontiers entitled ‘A novel electronic patient-reported outcome delivery system to implement health-related quality of life measures in routine clinical care: an analysis of five years of experience’.

The study sought to develop a simple and secure technological solution to incorporate electronic patient-reported outcomes (ePROs) into routine clinical care.

For the purposes of the study, a novel ePRO questionnaire delivery system was produced and sent from the electronic medical record (EMR) to patients with a number of conditions including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus or giant cell arteritis. Patients could complete the questionnaires on their own device or in the clinic waiting room. The study focused on describing the demographics and completion rates of three of the questionnaires; one on fatigue, one on depression and one on medical events and treatments experienced by the patient in the last three months.

The technology was made available for up to 111 rheumatologists in 42 clinics across six areas in Australia. Between April 2016 and December 2020, 221,352 of these questionnaires were sent from 39 of the 42 contributing clinics. Overall, 85 percent of patients completed at least one questionnaire, and of all the questionnaires sent, 73 percent were completed. The study found that females were more likely to engage with the questionnaires than males, with 87 percent of females engaging versus 81 percent of males. Older patients were also found to be slightly more likely to complete all questionnaires delivered.

The authors state: “Importantly, this high completion rate was also sustained over time and many patients had completed multiple ePRO questionnaires.”

They add that “patients expressed… desire for greater involvement in the management of their disease”, and note that in a recent study patients reported that reporting their own outcomes “improved communication and shared decision making with their rheumatologist and made the visit more patient-centred. This resulted in high satisfaction and confidence in their treatment.”

Despite the shift towards digital health, they observe, ePROs have not been widely implemented in routine clinical care, with main reasons cited including absence of suitable software and the difficulties and costs associated with implementing innovative software solutions.

They conclude that the system tested in this study “has overcome these hurdles and to the best of our knowledge is the first of its kind to allow seamless integration of PROs into the daily workflow of a large network of rheumatologists based nationwide across Australia. This solution not only supports real-time decisions made by clinicians and patients but also incorporates a successful mechanism for collecting quantitative data that opens the potential for these important data to contribute to EMR-based research, facilitating representation of the patient perspective.”

The study was conducted by Kathleen Tymms; Catherine OSullivan; Tegan Smith; Geoffrey Owen Littlejohn; Tim Freeman; David Hoffman; Dana Segelov; Hedley Griffiths; Sabina Ciciriello; Peter Youssef; David Mathers; and Claire T Deakin on behalf of the OPAL Rheumatology Consortium.

Citation: Tymms K, O’Sullivan C, Smith T, Littlejohn G, Freeman T, Hoffman D, Segelov D, Griffiths H, Ciciriello S, Youssef P, Mathers D and Deakin Claire T (2023) A novel electronic patient-reported outcome delivery system to implement health-related quality of life measures in routine clinical care: An analysis of 5 years of experience. Front. Digit. Health 4:1074931. doi: 10.3389/fdgth.2022.1074931



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