Segment 5: Developing Appropriate PRO-PMs

Patient-reported outcome measures help providers and health plans better understand what the patient wants and needs; however, there are still many challenges standing in the way of reaching its full potential, said Jason C. Goldwater, MA, MPA, senior director, National Quality Forum.

Patient-reported outcome measures are difficult to construct, as building these outcome measures needs to come from the viewpoint of the patient. Mr Goldwater explained that patient-reported outcomes must not only be designed to perform actions that would improve the quality of the patient’s care, but with insight that would help physicians better understand the care a patient needs.
“It’s a lot easier when you have an outcome measure that says if somebody comes in with a heart attack, give them aspirin right away, which now is somewhat of a common practice,” Mr Goldwater said. “It’s much more difficult to try to understand, ‘well what does the patient really want if they come in with these symptoms, or if they have these signs, or they have these concerns.’”
Additionally, Mr Goldwater said that finding the right tool that would be easy and engaging for the patient to use successfully is another challenge of patient-reported outcomes. The measure will be less accurate if the patient is either entering in the wrong information or not using the instrument to its full potential. Therefore, Mr Goldwater explained that patients need to understand what they are being asked and how to enter it appropriately in order for the measure to align with the patient’s information and concerns.
While there has been much recent progress in the development of patient-reported outcome measures, the task of just testing quality measures overall can take upwards of a year’s time. Patient-reported outcome measures are then more difficult to test because according to Mr Goldwater, the tools need to be compatible with the populations using them, and finding this pairing can oftentimes be difficult.
Although these kind of measures remain in their infancy, Mr Goldwater is optimistic of the impact these measures will have on the quality of care for patients in the future.
“I think there’s been a lot of progress made. I think the ability for patients to report data on themselves has significantly increased over the last 3 or 4 years,” Mr Goldwater said. “And, there’s a variety of ways to mine that data to really understand what patients are most concerned with and then being able to develop the tools appropriately or just to use that data directly.”
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