Throughout our health policy work and in our role co-leading the Consumer-Purchaser Alliance (C-P Alliance), the National Partnership advocates for higher quality, more affordable, patient- and family-centered health care. We know that achieving this vision requires the health system to partner with patients and families at every level: in care design, in policy and governance, and at the community level. We need to embrace patients, families and consumers, not simply as advisors, but as genuine co-creators of the health care system we are building.
For these efforts to be successful, the voices of patients and families must be heard, and consumers must be able to access information that allows them to make the best possible decisions. Purchasers and providers, too, must be able to understand what does and does not meet the needs of patients and families.
Patient-reported outcomes (PROs) are a critical tool in making that happen, and in putting patients and families at the center of care. PROs are the patient’s own assessments of how their physical and/or mental health has changed as a result of the health care they received. Access to PRO data can help patients make informed decisions about their treatment and help us hold providers accountable for delivering high-quality care that rewards value over volume. Unfortunately, adoption of PROs has been slow in the United States for a number of reasons:
- Lack of incentives for providers to work PROs into their routine workflow;
- Burden on patients of completing unduly lengthy PRO surveys, resulting in low response rates;
- High cost of capturing PROs, in part because it often requires using regular “snail” mail and because there is no easy way for providers to integrate PRO data into electronic health records; and
- Lack of consensus on how to build performance measures using PROs.
To help consumers and purchasers overcome these barriers, C-P Alliance has released an invaluable resource: Action Brief: Patient-Reported Outcomes. The brief is a must-read for all of us who want to make our health care system more efficient and effective. It provides examples of effective use of PROs, including for hip and knee replacement, depression, asthma, back and neck pain and more.
It also offers specific action steps for consumers, including:
- Request that health plans and providers share PRO data;
- Push policymakers to include PROs in public accountability, payment, and public reporting programs;
- For those with employer-sponsored health insurance, ask if PROs are considered during the benefits and plan selection process;
- Insist that programs use surveys that capture PROs in a concise way so that they are more convenient to fill out;
- Advocate for providers to allow patients to enter PROs into an online patient portal so they can more easily do it from home or during a clinic visit; and
- Demand standardization of both measures and survey instruments.
The full brief is here. I encourage you to read and share it, as we continue our collective efforts to create a health care system that delivers higher quality, better coordinated care at lower cost.
