The problem with collecting PROM data in healthcare

In value-based healthcare systems, understanding and improving patient health outcomes is central. However, capturing these data via patient-reported outcome measures (PROMs) is far from straightforward.

Widespread implementation of PROMs into clinical care has faced several barriers including use of lengthy paper-pencil questionnaires, operational issues associated with large-scale data collection, and lack of real-time integration with electronic health records.

The PROMinsight solution

Aligning with our vision to revolutionise how patient-reported outcomes are measured in research, clinical trials, and healthcare, the PROMinsight team has been working hard to find solutions to these barriers and overcome the difficulties associated with efficient PROM measurement in the Ophthalmology space.

Teaming up with Prof Freidman at Mass. Eye and Ear tertiary eye hospital in the US, we recently implemented our glaucoma quality of life CAT “GlauCAT^TM” in glaucoma clinics to test the feasibility and effectiveness of integrating PROM data using CATs into routine clinical care for patients with glaucoma.

How did it work?

Glaucoma patients attending clinic completed six AI-driven GlauCAT^TM QoL tests on an internet-enabled tablet: 

1. Ocular comfort – unwanted sensations in the eye, such as pain, discomfort, stinging, dryness
2. Activity limitation – difficulties doing daily activities, such as housework, reading, self-care
3. Mobility – difficulties getting around independently, such as using stairs and crossing a street
4. Concerns – worries about safety, falling, eyesight getting worse, and losing independence
5. Emotional well-being – emotional reactions, such as frustration, anger and helplessness
6. Treatment inconvenience – e.g. administering eye drops, or changes in treatment regimen

A real-time printable report summarizing quality of life domain scores, including a list of low-scoring items and details of referral services, was shared with physicians prior to consultation.

What were the outcomes of the study?

Overall, four glaucoma physicians participated in the initiative, which was extremely well accepted by patients, with over 200 patients agreeing to take part (89% acceptance rate).

The tests were user-friendly, with 4 in 5 patients able to complete the GlauCAT tests independently.

Most patients took only 8 minutes to complete all six GlauCAT tests (about 90 secs per test) with very few items per test needed to obtain a precise score, e.g. six items for Concerns and up to nine items for Mobility.

Almost two-thirds of patients reported discussing their GlauCAT results with their doctor, and feedback from doctors using the GlauCAT summary report was very positive:

“GlauCAT gave me information about the patient’s concerns in a simple format that was easy to glance at during a busy clinic.”

“It is a great concept to identify patients who may need extra vision rehabilitation services.”

“The GlauCAT results may have pointed out an unmet need in my patients”

“Let’s me know issues patients are having. I also like having a score as well as the specific questions to help focus discussion”

What next?

The PROMinsight team are working hard to improve user experience by enabling patients to complete GlauCAT^TM prior to their glaucoma appointment via a secure link to the PROMinsight platform, and establishing full integration with the Epic electronic medical records (EMR) system.