I’m Judy Baumhauer, a professor of Orthopaedics at the University of Rochester and medical director of PROMIS, a computerized assessement system that captures and tracks patients’ perspectives on their care. I am an Orthopaedic surgeon, and medical director of the University of Rochester’s program to incorporate PROMIS across our entire medical system. Our goal is to invite every patient to share their perspective on the effectiveness of their health care so we can learn from patients, and improve the overall quality of care we deliver.
PROMIS is a National Institutes of Health-sponsored system that was developed at Northwestern University. It’s been shown to be a very accurate way to measure how well a patient is progressing. The system asks patients a variety of questions on their pain, physical function, and state of mind, or mood, to assess their health care outcomes. It uses smart testing and asks the following question based on the answer to the prior question. This way the patient does not get the same set of questions at the next patient visit.
At the University of Rochester, 30 programs use PROMIS in their outpatient clinics and more programs are continuing to adopt it. We offer the assessment at every outpatient visit and participation is voluntary for patients. We hand patients a tablet when they check in for their appointment, and they spend less than 3 minutes answering multiple-choice questions about their pain level, mood, and ability to manage everyday tasks like walking, exercise and housework. When patients complete the survey, their scores go into their health record, and their health team can view that day’s results – plus their previous scores– on a computer before or during the patient appointment.
Health teams use the patient input to assess how an individual patient is progressing; collectively, the data can yield insights on the benefits of particular therapeutic approaches. Patients’ input on what worked for them – and what didn’t – is building a kind of health care “trip advisor.” But rather than being an online reference for other patients, this tool will be a road map for health providers as they seek the best care pathways for future patients. Many health care organizations around the world are interested in the potential for patient-reported health assessments, but it can be challenging to add this activity to clinical environments that are already very busy. UR is one of the world leaders in designing a system that works well in a clinical setting, and puts patient insights to work in improving care. We’ve been benchmarked by academic medical centers from the U.S., Europe and Asia who are working to adopt PROMIS in their clinical environments.
I’ll start answering questions at 1 p.m. EDT. AMA!
Hi and thank you for being here today, .. my question to you is do insurance company have access to that information and could it be used against the "customer". thank you
No, insurers do not have access. This data is part of the patient's private HIPAA chart and is not provided to the insurers. The power of this wide spread data collection is in understanding group data and allowing patients benefit from knowing the outcomes of thousands of other patient like them.
Thanks for this AMA. So far, has the feedback from PROMIS prompted y’all to consider or implement changes in patient care and recovery?
Yes, we have looked at the patient reported outcomes information (PROMIS) and have been using it on an individual basis to guide shared decision making with the patients. A graphic display makes it very easy to view and understand. We also have grouped the data to determine threshold values identifying patient who will and will not benefit from some common orthopaedic surgeries.
How does this system address the differences in patients' personalities and outlook on their care? Some people are more negative than others and may rate their recovery lower than someone else would, for example. How do you know that you're getting an accurate picture of how a patient is really doing?
Since these are outcomes from the patient's voice, how they report this information is how they feel about their pain, function, mood etc. Often I think the important aspect may not be the absolute value obtained but rather the change of the value over time. This reflects improvement or not from treatment.
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