Patient-Reported Outcomes Used Minimally in Hospitals, But Future Looks Promising

CMS recently launched an initiative that uses patients’ view of their health as a meter for determining how to pay the provider. Patient-reported outcomes (PROs) were initially implemented into the new CMS program as a way to lower the costs of knee and hip replacements, but more broadly, the proposed Merit-based Incentive Payment System is intended to restructure the way Medicare will eventually pay for nearly all medical services. However, a recent study found that hospitals aren’t quite yet jumping on board.

Health Catalyst recently published a survey that sought to examine how hospitals are implementing these new strategies of payment, or if they are at all. Researchers discovered that of the 100 clinical and administrative executives from health systems of all sizes across the nation, only about 18% consistently use PROs and that additionally, less than one-fifth of the respondents said they regularly review the measures to guide medical care.

The survey also revealed several key barriers to implementing PRO measures in the clinical setting. More than one-third (36%) of survey participants said money and/or time was the most significant barrier, 26% said fitting PROs into the daily workflow of the clinician was an issue, 15% cited technology, and a smaller handful of respondents reported either organizational resistance to change or lack of leadership support as a barrier to implementing PROs.

“Patient-reported outcomes are critical to enabling healthcare’s evolution away from focusing on the volume of services delivered to the value created for patients,” Paul Horstmeier, senior vice president of Health Catalyst, said in a statement. “Their use promises seismic changes not only in the way providers are paid, but how they measure success, how patients choose their doctors, and most importantly how clinical outcomes are improved. Yet with few exceptions our nation’s hospitals are unprepared for the shift and need help managing this new priority within the ever-shifting field of time-intensive regulatory requirements.”

Caleb Stowell, MD, vice president of standardization and business development for the International Consortium for Health Outcomes Measurement (ICHOM), added that PROs are growing in importance in medical care, as the question is no longer about survival but of what the patient’s quality of life will be like after treatment. The ICHOM has already been able to identify standard sets for about 20 conditions, which encompasses 45% of the global disease burden, and is currently working with providers and health systems in the US and abroad in the efforts to adopt these standards.

While many health systems may not be widely using PROs today, the future looks promising. The Health Catalyst research team found that 72% of the survey respondents who said they rarely, or never, use PROs reported that they plan on beginning to employ these measures within the next 1 to 3 years.