Patient-reported outcome measures (PROMs) have become an important part of the reimbursement process for practices since being incorporated into the Merit-based Incentive Payment System (MIPS) and Medicare Access and CHIP Reauthorization Act (MACRA) requirements.
With the Health Department aiming to have 50% of all Medicare payments tied to these quality-based payment models by 2018, failing to meet these requirements can harm a practice’s chances for full reimbursement.
Compliance aside, PROMs can make a significant contribution to the quality of care at your practice. The more data you can make available, the more your practice can learn.
Yet only 35% of orthopedic practices are collecting the data. What’s holding everyone back? Here are the major obstacles for practices when it comes to PROM, and what they can do to overcome them.
Gathering Information
Problem: One of the biggest issues is simply gathering information from patients. The most common method is to send patients a personalized questionnaire shortly after surgery, to track their recovery — but getting them to respond can take time, and more resources than practices can afford.
Most staff are busy enough performing their regular everyday tasks; reassigning them to follow up with patients can result in them failing to do either job properly.
Solution: Introduce an easy-to-use software interface for entering PROM data. Though this could be custom-developed for the clinic, adapting a ready-made program would likely be faster and more cost-effective.
There is a growing trend in the use of mobile apps to make it easier for patients to respond. Though this relies on patients’ willingness to enter data on their own, the results would be greater patient engagement and potentially more accurate results. Studies have found that this is the most effective method to improve PROM.
Syncing PROM and EHRs
Problem: Practices are not always able to use the data from their EHR systems needed to generate the right questions for capturing patient outcomes. Some systems do not capture all the critical data points in discrete data fields.
The lack of basic data such as procedure codes and surgery dates makes it difficult to automatically generate the appropriate survey for the patient to complete. This missing information can have a negative impact on the practice’s results.
Solution: If your EHR or PM system cannot generate this data, there are low-tech solutions to fixing this issue, like using Excel spreadsheets. This will still involve a manual process of data entry, but the data will be more relevant and precise than relying on your Practice Management system.
A more accurate solution is to use surgical scheduling software, like Surgimate, where the information about a surgical event required by the patient outcome system has already been captured. These software solutions enable the most appropriate questionnaire to be sent to the patient without relying on system ‘workarounds.’
Analyzing PROM Data
Problem: Once you’ve gathered and synced the data with your EHR, you’re ready for the final step: analyzing and reporting on the data. Though this is critical for the data-driven decisions you need to make to improve patient care, sorting through the data can be tedious.
Solution: There are some great programs available to help practices collect and analyze data, including OBERD, CODE Technology, and Health Loop. Programs differ in the amount of patient engagement required and in the analytical tools they offer.
No matter what program you use, it is important to know what data to look for. Take tracking post-surgery recovery, for instance. Looking for patterns, such as practice-patient interaction post-surgery, or information given to the patient, can offer insight into what is helping or hurting patient recovery.
Many tools also let you check your results against benchmarks, e.g. the rest of the surgeons at your practice, or other surgeons in your specialty area.
Get Your PROMs in Order
As healthcare authorities push to standardize PROMs across practices nationwide, it’s important to get ahead of the game. Gathering patient information properly and using it smartly can improve the likelihood of quality care reimbursements.
