Development and evaluation of patient-reported outcome score visualization to improve their utilization (PROVIZ)

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ABSTRACT: Development and evaluation of patient-reported outcome score visualization to improve their utilization (PROVIZ) Understanding how health information technology (IT) can facilitate the use of patient-reported outcome measures (PROs) to improve clinical management, health outcomes, and patient engagement is of high importance (NOT-HS-16-015). Assessing the patient’s experience of illness and wellness is key to informing their goals of care and clinical management. When building PROs into the electronic health record (EHR), health systems, researchers, and clinicians must investigate the optimal methods and impact of collecting and sharing PRO and patient contextual data with clinicians and patients in order to have positive effects on clinical care, quality of life, and outcomes in a practical way. Even with PROs integrated into our EHR, we found that clinicians do not always know how to interpret and use the data to inform patients and clinical management. Therefore, the goal of this study is to develop and test PRO visual presentations for the EHR through research based on engineering and human-computer interaction principles to inform optimal data visualization and presentation. These data visualizations will be evaluated formally, focusing on outcomes of the usefulness, acceptability, and understanding of the scores by clinicians and patients. This developmental, mixed-methods study will include three components: 1) qualitative interviews with both clinicians treating patients with hip and knee pain or osteoarthritis and the patients themselves to understand their current perception of PROs and preferences for data presentation, and 2) subsequent development of data visualization prototypes that attempt to meet clinician and patient preferences, followed by 3) formal evaluation and iteration of the novel visualizations with those stakeholders. Our specific aims are to evaluate patient and clinician preferences, understanding, usability, and acceptability of modes of PRO score presentation in the ambulatory setting. This transdisciplinary study builds on our 10 years’ experience with collecting PROs and our two years’ experience with a clinical informatics project to implement PROs into the EHR. Our team includes expertise from computer science, health services research, and orthopedic surgery. Improving visualization of PRO scores is the next step in ensuring that PROs inform clinical management conversations between patients and providers. In addition to improving clinical care, this will bolster the importance of PRO assessment completion for patients, thereby enhancing future comparative effectiveness research that incorporates PRO data into analysis plans. Future studies will use high-quality PRO data with clinical and patient contextual information to investigate compelling questions in the field, such as risk stratification to aid treatment decision-making with patients from orthopedic surgery and rheumatology settings. This study targets AHRQ priorities, including a focus on “how health IT can facilitate the collection and use of PROs and patient contextual data to improve the quality and outcomes of care in primary and other ambulatory settings.” !