Federal Register - August 27, 2021
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Source: Federal Register
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Federal Register / Vol. 86, No. 164 / Friday, August 27, 2021 / Notices PRO categories and discusses best practices for PRO selection In cllnlcal care. Patient, family member, and caregiver Involvement are critical components of PRO selection to ensure the Information ls meaningful, and thts perspective should accompany a multlstakeholder selection process that also Includes cllnlclans, researchers, and other experts. key takeaways lndude the Importance of ldentlfying the overarching cllntcal goals that PROs shculd meet and the Importance of keeping actlonablllty and teaslb!Uty In mind throughout the selection proc85$, The final report also discusses how to select the corleet PROM for an organization In order to .collect data and generate u.sable information to help Inform patient care. The multistakeholder selection team should understand thatPROMs exist on a continuum of speelflctty and range from disease agnostlt to dlseasespeclflc, each With Its unique set of advantages. Patients bring rmportant perspectives to questions arounc:I burden e.g., how long it takes.to complete each PROMr modes e.g., whether a PROMIS selfac:lmlnlstered or completed via Interview! and methods e.g., whether a PROM
Is completed via paper; email, or patient portal. Involvement.by providers and other experts ls also Critical when selecting PROMs, as these stakeholders can inform the perceived value. of different PROMs in improving care. The final report reviews and expands upon the attributes of PROMs that were discussed In past literature and that should be considered during the selection process. Five best practices for PROM selection are Introduced, and an attribute grid Is presented as a tool to ald In comparing and selecting them.
The final technical report explores best.and prorrilslng practices related to the implementation of PRO Ms. Buy-in from patients, clinicians, leadership, and other key stakeholders is arguably the most critical aspect of Implementation, and the report offers guidance on securing buy-In. The burden .of data collection affects both clinical staff and patients, and recommendations are proVlded to minimize this.
burden. Workflow implementation is addressed, including the opportunities to delegate. tasks around the collection, interpretation, and communication of outcomes data. appropriately across clinical and support staff. C1Iniciansn:1ust be able to accurately Interpret scores and communicate effectively With patients about what the scores mean, and recommendations are Included to lmprove interpretation and cornmunlcation. Promising practices are explored around the integration ofPROMswlth EHRs, as are the tmpllcatlons of using return-on-investment and patient and physlclan-lncentlves asa prlmaryway to measure the cost, value, and benefit of PROMs. Using three cllnlcal scenarios bums and trauma, heart failure, and joint replacement as ex.itnples, the pi:oJect ex.imined key elements of PROMS
and assessed use cases for different peopfeJnvolved In the selection process.
Building a Roadmap From Patient-Reported OUtcome Measures to Patient-Reported OUtcome
Performance Measures
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In the foreseeable future, measure developers will create dlgital PRO-PMs that are based on high quality PRO Ms; EHR systems will not only collectllata for those PROPMs, but will also calculate and submit aggregate scores for regulatory and reimbursement. purposes. For this.to occur, measure developers need step-by-step guidance to help Identify attributes Of high quality i>ROMs and create digital PRO-PMs thahre based on those PROMs. NQf will .create this guidance, or roadmap, by convening a TEP that consists of measure developers; health rr experts; clinicians and representatives of professional societies; professionals Tnvolvell In payment, relmbul"Sement; and purchasing; and patients. This work will be viewed through the lens l>f chronic pain and functional llmltatlons, two areas with deep knowledge of patient-reported measures.
