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

摘要：开发和评价患者报告的结局评分可视化，以改善 利用（PROVIZ） 了解卫生信息技术（IT）如何促进患者报告结果的使用 改善临床管理、健康结局和患者参与度的措施（PRO） 重要性（NOT-HS-16 - 015）。评估患者的疾病和健康体验是告知 他们的护理和临床管理目标。当将PRO构建到电子健康记录（EHR）中时， 卫生系统、研究人员和临床医生必须研究收集和使用这些信息的最佳方法和影响， 与临床医生和患者共享PRO和患者背景数据，以便对临床 护理、生活质量和实际结果。 即使PRO集成到我们的EHR中，我们发现临床医生并不总是知道如何解释和使用 这些数据可以为患者和临床管理提供信息。因此，本研究的目标是开发和测试 通过基于工程和人机的研究，为EHR提供PRO视觉演示 交互原则，以实现最佳的数据可视化和呈现。这些数据可视化将是 正式评估，重点关注评分的有用性、可接受性和理解结果， 临床医生和患者。这种发展性的混合方法研究将包括三个组成部分：1）定性 与治疗髋关节和膝关节疼痛或骨关节炎患者的临床医生和患者的访谈 了解他们目前对PRO的看法和对数据呈现的偏好，以及2） 数据可视化原型的后续开发，试图满足临床医生和患者 偏好，然后是3）与这些利益相关者一起对新的可视化进行正式评估和迭代。 我们的具体目标是评估患者和临床医生的偏好、理解、可用性和可接受性 在门诊环境中PRO评分呈现模式。 这项跨学科的研究建立在我们10年收集PRO的经验和我们两年的 具有将PRO实施到EHR中的临床信息学项目的经验。我们的团队包括专业知识 从计算机科学，健康服务研究，整形外科。改善PRO的可视化 评分是确保PRO告知患者之间的临床管理对话的下一步， 提供商除了改善临床护理外，这将加强PRO评估完成的重要性 从而加强未来的比较有效性研究，将PRO数据纳入 分析计划。未来的研究将使用高质量的PRO数据以及临床和患者背景信息， 调查该领域令人信服的问题，如风险分层，以帮助治疗决策， 来自整形外科和风湿病学机构的患者。这项研究的目标是AHRQ的优先事项，包括 重点关注"健康IT如何促进PRO和患者背景数据的收集和使用，以改善 在初级和其他流动环境中的护理质量和结果。" !

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.” !