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The importance of patient reported outcomes.
Today, the U.S. has the largest number of known COVID-19 cases in the world. The impacts of the pandemic on the healthcare industry are two-fold, impacting both patients and providers.
For providers, COVID-19 has created evolving workflow challenges for clinicians. For example, teams are now having to rapidly adopt virtual models of care in order to continue to treat patients with chronic health conditions as well as acute health needs unrelated to COVID-19. Additionally, resources are scarce from the surge of COVID-positive patients, creating the need to ration medical equipment and interventions, which results in additional challenges in the overall pandemic response.
On the patient side, coronavirus has also initiated a ‘new norm.’ Those who regularly saw their clinicians prior to the pandemic, especially chronic disease patients, are having to adapt to new protocols such as additional pre-appointment screenings or telehealth visits in place of in-office appointments. For patients with COVID-related symptoms, many are unsure when and where to seek care, resulting in further overcrowding in urgent cares and emergency rooms. Even worse, this uncertainty has also resulted in a rise of at home deaths. Other patients are also feeling the pressure of lockdowns and quarantines, experiencing limitations in access to food and medicine, posing a threat to their overall mental health.
To little surprise, many of these challenges are exacerbated in medically-underserved communities, which also happens to be those at greatest risk of morbidity and mortality due to COVID19. Understanding these challenges, our industry must come together to provide healthcare systems tools needed to better manage their ever-evolving workflows, while also ensuring patients remain at the forefront.
The Value of Patient Reported Outcomes During COVID-19
Fortunately, we have tools and technologies available - including tech-enabled patient reported outcomes (PROs) - to better assist physicians working on the front lines throughout the pandemic. A PRO is a health outcome directly reported by the patient who experienced it. PROs include survey tools that capture a patient’s experience in their own words, providing clearer insights into all aspects of a patient’s health.
Given today’s current state of affairs, PROs are even more valuable for providers. When adopted and easily integrated within the clinical workflow, PROs can be used to provide ongoing support and communication between providers and patients, also enabling providers to better monitor patients with milder symptoms or exposure risks of COVID-19 before they become too severe, and contribute to the rise of at home deaths.
Best Practices for PROs During COVID and Beyond
Collecting PROs during COVID-19 allows physicians to answer questions like: Who needs medical follow-up? Who is having trouble getting their medication or food during social distancing? Who is struggling with loneliness or depression? As a result, patients can be connected to the right resources or physicians can then deploy action as needed.
When implementing PROs, there are a few best practices to keep in mind:
â PROs should be integrated into the EHR via FHIR - By integrating into the electronic health record system, patient results can be available to the care team in real time in order to be actionable. One way to ensure this action is through FHIR apps, which can be used to identify patients in need of clinical interventions and collect data for research studies. More importantly, having PROs integrated through FHIR enables interoperability, expands the scopes of available measures, streamlines questionnaire management and allows PROs to be easily understandable by technically adept personnel.
â PROs should be delivered to patients with the least friction possible - Despite strong numbers supporting adoption of patient portals, studies reveal that patient portal use rates are actually less than one-third of patients, in part due to poor usability and functionality. Alternatively, PROs can be administered through other methods, including text-messages, which proves to be more effective in reaching medically-underserved or high risk groups who might not have access to a computer or internet.
â PROs should efficiently connect patient responses to clinical action - Initiating new tech can be a daunting task for healthcare administrators, especially during a patient surge like many health systems are experiencing now. But PROs can be deployed quickly and easily, without having to connect to new devices and no need for expensive custom integration work. By seamlessly integrating into the current workflow, PROs can drive patient responses into actionable data. For example, patients struggling with mental health can be connected to a counselor for a virtual visit or for patients who no longer have access to their necessary daily medications can be enrolled in prescription delivery services.
Today’s healthcare “new norm” is anything but normal. But we have an opportunity to better assist providers -- both during the coronavirus pandemic and beyond -- by integrating PROs into the clinical workflow as part of the permanent medical record. As a result, healthcare providers can act on quality, data-driven feedback to provide better treatment options for patients. This is essential in order to proactively manage better patient outcomes and best practices - both during the COVID outbreak and beyond.
About the Author
Lucienne Marie Ide, M.D., PH.D., is the founder and chair of Rimidi, a cloud-based software platform that enables personalized management of health conditions across populations. She brings her diverse experiences in medicine, science, venture capital and technology to bear in leading Rimidi’s strategy and vision. Motivated by the belief that we can do so much better as individuals, an industry and society, Lucie left clinical medicine to join the ranks of healthcare entrepreneurs who are trying to revolutionize an industry.