PARIS – Combining e-mail and office-based technology garnered patient-reported outcomes from more than 90% of patients receiving orthopedic care, in an analysis of 18,073 physician-patient encounters.
"Integrating [patient-reported outcomes] measurement into orthopedic standard of care without interrupting clinical practice is possible and currently in use," Xiang Zhou, Ph.D., reported at the World Congress on Osteoarthritis.
Patient-reported outcomes, or PROs, have taken center stage in recent years as a way to measure the safety and effectiveness of total joint arthroplasty, with respect to both technical and patient satisfaction.
New York University Langone Medical Center implemented an IT system in May 2012 for all nine adult orthopedic reconstructive surgeons at its Center for Musculoskeletal Care. Patients with e-mail addresses on file were sent a link to a PRO questionnaire, individualized to their clinical needs, 3 days before their appointment. A reminder e-mail was sent the day before their visit if the questionnaire was not completed. Tablets were also distributed in the waiting room for patients who did not complete via e-mail. Real-time and previous PRO scores were available in the electronic health record for physicians to review during the examination.
PRO records were captured for 83% of 8,864 patients seen in 20 months. Of those, 72% had multiple, longitudinal PRO scores recorded, according to Dr. Zhou, a research scientist in NYU Langone’s orthopedic surgery department.
Of the 18,073 physician-patient encounters, 71% included a completed PRO score. Monthly completion rates ranged from a high of 91% to a low of 56%.
"Reaching more than a 90% PRO collection rate is possible with the support of participating physicians," he noted.
Patients under age 65 had a significantly higher overall PRO completion rate than did older patients (76% vs. 65%; P less than .001), as did males vs. females (73% vs. 70%; P less than .001), Dr. Zhou reported at the meeting, sponsored by the Osteoarthritis Research Society International.
In all, 55% of patients who provided an e-mail address completed their PRO questionnaires via e-mail. In that subset, no significant differences were seen by age (55% both groups; P = .996) or gender (56% male vs. 55% female; P = .752).
PRO scores are now included in the electronic health record and routinely captured and used by physicians.
"Routine real-time and longitudinal PRO reports are a valuable tool to stimulate patient-physician communication and inform treatment decisions," the authors concluded in the poster presentation.
Dr. Zhou reported having no financial disclosures.