Fleur Fritz Institute of Medical Informatics Panel Presentation 24th June ARM 2012 Orlando
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1 Integrating Patient-Reported Outcomes into EHRs Fleur Fritz Institute of Medical Informatics Panel Presentation 24th June ARM 2012 Orlando
2 Integrating Patient-Reported Outcomes into EHRs INTRODUCTION
3 Patient Questionnaires Use in Medical Care and Research Patient reported outcomes are important to: Assess the patient s perception of their health status, e.g. quality of life Realize gap between patient-based and physician-based assessment Documented in: Clinical studies (sometimes) Routine patient care (rarely)
4 Patient Questionnaires Use in Medical Care and Research logistical challenges in collecting, storing, analysing, and reporting PROs in real-time have been a barrier to their use in practice 1 Patient t reported outcomes documented d by patients t Manual data transfer into the EHR and/or research database time- consuming and error-prone Single Source Approach: Capture medical data once and reuse it for different purposes (treatment, research, quality management, etc.) 1 Snyder C, Aaronson N. Use of patient-reported outcomes in clinical practice. com 2009.
5 Research Question Is there an efficient and user-friendly method to collect patient reported outcomes data by means of patient questionnaires which can then be integrated into the EHR to be used for treatment as well as for research purposes?
6 Integrating Patient-Reported Outcomes into EHRs METHODS
7 The Web-based based Application Hardware-independent Currently supported questionnaire forms: radio-buttons and visual analogue scale XML file for data export Mapping to EHR form data elements According to usability standards
8 The Web-based based Application Competence Center for the Diagnosis and Therapy of Chronic Pruritus Three different patient questionnaires (DLQI, HADS, PBI) Evaluation: More than 100 patients per month (paper-based p and electronic workflow) Time and cost measurements Patient/Staff questionnaires regarding usability (SUS) and acceptance
9 Integrating Patient-Reported Outcomes into EHRs RESULTS
10 Workflow o
11 Screenshot Application Demo
12 Evaluation - Costs Personnel costs (manual data transfer) and material costs (paper, p staples, printing, energy, ) per paper sheet = Euro vs. Material costs for ipad and accessories ipad paid off after 7 months compared to paper-based workflow
13 Evaluation - Usability System Usability Scale Score: 80 from 100 (return rate 94%) Patients: [ ] I just see advantages, even though I am not a fan of computers. It is much better to read and clearly arranged and it was not difficult at all. - It was really fun! Physicians: [ ] it has a significant influence on the treatment. For example when I see that t a patient t has a high h depression score I choose a different medication, this is not possible when I use the paper based version. - I would recommend it to other departments.
14 Integrating Patient-Reported Outcomes into EHRs DISCUSSION
15 Advantages of Mobile Questionnaires Time saving Reducing transcription errors Increased data quality Patient reported outcomes data integrated in the EHR is immediately available for treatment and reusable for research
16 Integrating Patient-Reported Outcomes into EHRs FUTURE RESEARCH
17 Future Research Implementation in other hospitals and primary care More questionnaire types (e.g. catalogue selection) Diaries at home
18 Thank you for your attention. t Fleur Fritz*, Sebastian Balhorn, Markus Riek, Bernhard Breil, Martin Dugas *Institute of Medical Informatics University of Münster Albert-Schweitzer-Campus 1 / A11, Münster Sonja Ständer University of Münster, Department of Dermatology
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