Integrating Patient Reported Measures

(PRMs) into clinical practice

Gill Hartas | Patient Reported Measures/Health Outcomes

Using Patient Reported Outcomes to Impact Change Friday 9th November 2018

The ACI acknowledges the traditional owners of the land that we work on

We pay our respects to Elders past and present and extend that respect to

other Aboriginal peoples present here today.

Introduction animation

What’s happening across the state for the LBVC

Clinical Initiative Areas?

• Management of Osteoarthritis

• Osteoporotic Refracture Prevention

• Diabetes High Risk Foot Services

• Inpatient Management of Diabetes Mellitus

• Management of Chronic Heart Failure

• Management of Chronic Obstructive

Pulmonary Disease

• Renal Supportive Care (End Stage Kidney

Disease

• Adverse Events: Falls in Hospitals

• Hip Fracture

• Early access to colonoscopy

• Breast cancer treatment: hypo-fractionation

• Management of bronchiolitis

Measures

• PROMIS-29

• HOOS or KOOS

• Oxford Hip or Knee

• Integrated Patient Outcome Scale (IPOS Renal)

• COPD (CAT)

• DASS-21

• Falls Efficacy Scale

• Cardiff Wound Impact Schedule Questionnaire

• Diabetes Distress Scale (DDS)

• St George Respiratory Questionnaire

• Kansas City Cardiomyopathy Questionnaire

(KCCQ)

• Inpatient PREMs, Outpatient PREMs &

Bronchiolitis PREMs

PROMs Patient Journey

John Farnham

2 Strong Hearts Street

The Last Time County

NSW 2000

This will be the last time

1 is the loneliest number

Example PREM Reports

What do PROMs mean to patients and clinicians?

Consumer:

“I was able to sit and reflect on

things that had been happening

in my life… It gave me the words

and started the conversation with

my doctor about things I wanted

to talk about”

Clinician:

“I thought that I knew my patient,

I thought I had a good rapport,

but when they filled in the PRMs

I realised that I didn’t know about

some key areas”

Clinician:

“ If only I had these results all the

time for all my patients, I would

be able to see what they were

really coming in for and address

that first”

Consumer:

“ I liked the fact that I could sit

down and do the questions in my

own time and then my physio

would talk to me about them and

what it meant for me”

Current state

Current state: Patient Reported

Outcome Measures (PROMs)

• REDCap (Research Electronic Data

Capture)

• Multiple logins and systems

• Manual scheduling

• Only can see service data

• Limited reporting functionality

• No local administration

Current state: Patient Reported

Experience Measures (PREMs)

• External provider

• No local administration

• Costs associated with tablet hire &

programming

• Reports not easily customized to

meet site needs

• Relies on ACI for administration

• Only for PRMs (multiple tablets to

carry around)

Process so far

Current IT System

• Formative evaluation

• User Acceptance Testing

• Agreement on core measures for use

across Integrated Care and Leading

Better Value Healthcare initiatives

• Capability development

• Input into the functional and business

requirements of new IT system

Future IT System

• Lengthy procurement process

including demo of 2 x vendors

• Partnership between ACI, eHealth and

the NSW Ministry of Health

• Implementation Planning Study (IPS)

workshops

• Finalisation of functional and business

requirements

• Change and adoption strategy

• Data linkage and evaluation

IT solution build

• Stand alone system

• Existing Integrated Care & LBVC sites

Phase 1

• Integration with PAS & Cerner eMR

• Roll out across all LBVC sites

Phase 2• Integration with

GP software (Best Practice & Medical Director)

Phase 3

Implementation Planning Study

Workshops

people participated in the Implementation

Planning Study (IPS) Workshops14110Workshops

Clinicians Consumers LBVC Leads

General Practice / Primary Health Network reps

Attended by:

PRMs Resources to support implementation

Website Newsletter Online eLearning

modules

Community of

Interest

https://www.aci.health.nsw.gov.au/make-it-happen/prms/resources/newsletter

What’s

next?

Online consumer eLearning module

www.aci.health.nsw.gov.au/make-it-happen/prms/resources/online-training

*New videos*

Support positions

• Funding for PRMs Project Officers across NSW to support the

implementation of the PRM IT system and use of PRMs more broadly.

• PRMs Project Officers will work closely with the ACI to ensure that PRMs

are continued to be embedded into routine clinical practice and service

improvement efforts.

• The positions will help to increase the capability of their district

Patient Reported Measures

Questions

Level 4, 67 Albert Avenue

Chatswood NSW 2067

PO Box 699

Chatswood NSW 2057

T + 61 2 9464 4666

F + 61 2 9464 4728

aci-info@health.nsw.gov.au

www.aci.health.nsw.gov.au

Gill Hartas

Project Officer

Patient Reported Measures

Gill.hartas@health.nsw.gov.au

www.aci.health.nsw.gov.au/make-it-happen/prms