Table 3.
Summary of NMPRO challenges and recommended solutions
| Aspect | Challenges | Recommendations |
|---|---|---|
| Task/workflow | Patient resistance to PRO completion | Provide patients with educational materials regarding the purpose, use, and security of PROs via handouts, videos, and online resources |
| Limited time for patients to complete assessment in exam room | Increase opportunities for PRO collection in various settings, such as patient’s home, waiting room, and exam room | |
| Reviewing PROs disrupts clinical encounters | Provide simple and actionable PRO results with vivid data visualization to save time for providers | |
| Technology | Lack of various types of data visualization | Incorporate tools to represent and view data in multiple ways |
| PRO results are not available for direct integration into clinical notes | Pull PRO results into the Note using existing EHR tools | |
| Desktop computers are inconvenient for certain patient populations (eg, wheelchair users) | Provide tablets or other mobile devices for PRO collection in the clinic | |
| PRO assessments are only available in English | Offer PROs in other languages and allow patient to select desired language | |
| Patient referrals are not routed to specific social workers | Provide automatic separation/labeling of patients based on their clinic and primary physician | |
| Individual | Not fully aware of the value of PROs | PROs should include relevant and validated measures based on the needs of a clinic; explicate the clinical utility of PROs to providers through training |
| Unsure how to make use of the data | Need more research and guidance on recommended clinical action with PRO scores; provide actionable data presentation | |
| Lack of incentives | Incentivize and support routine use of PROs through improved payment models (eg, incentivize providers based on the number of clicks on PRO results) | |
| Lack of training and education | Conduct training tailored to specific providers through emails, clinic meetings, and one-on-one meetings; engage physician champions |
EHR: electronic health record; NMPRO: Northwestern Medicine Patient Reported Outcomes; PRO: patient-reported outcome.