Paper 78: Integrating PROM Collection for Shoulder Surgical Patients through the Electronic Medical Record: A Low Cost and Effective Strategy for High Fidelity PROM Collection

Abstract

Objectives:

Patient Reported Outcome Measures (PROMs) are critical measures of quality of care and treatment outcomes; however, they are challenging to collect without significant financial and administrative investment. The purpose of this study was to evaluate the efficacy and cost of an automated PROM collection through the electronic medical record for shoulder surgery patients in a large, integrated healthcare system.

Methods:

An existing, electronic medical record (EMR) based, automated, PROM scheduling system was integrated into the surgical check-in workflow for all elective primary total hip, total knee, and partial knee arthroplasty patients from November 2020 through August 2021 at 3 high volume surgical sites in a large, integrated health system. Rates of completion for Patient Reported Outcomes Measurement Information System Upper Extremity (PROMIS-UE), Patient Reported Outcomes Measurement Information System Pain Interference (PROMIS-PI) and American Shoulder and Elbow Surgeons Shoulder (ASES) surveys were determined. No additional staff were hired to assist in PROM collection. In our institution, if the patient had an ambulatory appointment within 25 days prior to surgery, their PROM scores were marked complete and were not reassigned on the day of surgery (DOS). For all other patients, PROMs were assigned by the automated system on DOS.

Results:

A total of 325 patients with a mean age of 42 + 28 years were included in this study. The vast majority, 94% (306), were assigned surveys on their day of surgery as a result of the automated system. The other 6% (19) had PROM scores completed in the ambulatory setting as they had a pre-operative visit less than 25 days prior to surgery. For patients completing PROMS on their day of surgery, 87% (266/306) completed at least 1 of PROMIS-UE or ASES, while 82% (251/306) completed both. In total 88% (285/325) of patients completed at least 1 PROM on or within 25 days prior to surgery and 85% (277/325) completed both. This entire system cost $5180 to deploy.

Conclusions:

A native PROM scheduling and collection system was successfully implemented with a survey completion rate of 82% to 95% of patients. This system serves as an efficient, low-cost model for other surgical departments to leverage existing systems to collect day of surgery PROMs.