Patient-reported outcome measures (PROMs) are utilized to improve and assess the quality of care provided by orthopaedic surgeons to their patients. The American Academy of Orthopaedic Surgeons (AAOS) recognizes the significance of patient-reported outcomes (PROs) in treatment plans and value analyses. To facilitate the effective implementation of PROMs in orthopaedics, the AAOS has developed a portfolio of tools and resources as part of its “PROMs in Practice” initiative. This initiative aims to raise awareness and understanding of PROMs usage at the point of care, offer solutions to enhance access to technological solutions, and advocate for improved legislative and payer support on behalf of AAOS members and their patients. Orthopaedic care teams across the U.S. are urged to take note, as PROMs are increasingly being used as a crucial quality measure by both public and private payers to determine reimbursement and publicly report outcomes.
“Patient-reported outcome measurements about health status — such as pain, physical mobility, emotional well-being and experience of care — have been routinely used in clinical trials to test the impact of medication and other treatments on improving patient care. These types of measures will soon be required for use in orthopaedic performance measurement,” said Kurt P. Spindler, MD, FAAOS, AAOS PROMs workgroup chair. “The new AAOS PROMs user guide, scoring tool and other high-quality resources distill knowledge and expertise from a broad range of stakeholders and orthopaedic experts to provide a set of best practices to facilitate an organization’s ability to implement and utilize PROMs.”
Guiding Orthopaedic Surgeons, Patients and Data Forward
Even with the obvious benefits of shared decision making with patients, there are real and perceived barriers around the implementation of PROMs in clinical practice that have inhibited their broad adoption. A recent survey that invited all AAOS members to characterize their PROMs usage found that the two most common barriers to the implementation of PROMs into practice among AAOS members across all practice settings were concerns about staff burden (72%) and challenges in patients completing PROMs (69%).
“Despite great advances in patient-reported outcome measurement, there is still much ground to be covered as far as making it simple for orthopaedic surgeons to incorporate PROMs measurement into routine clinical care, including standardization of tool selection, validation of tools, efficient measurement of PROMs, integration with the electronic health record, and identifying and understanding clinical use cases across all orthopaedic subspecialties,” said AAOS President Kevin J. Bozic, MD, MBA, FAAOS.
With the vast majority (89%) of survey respondents who identified PROMs as moderately to highly important, the AAOS “PROMs in Practice” initiative will support orthopaedic surgeons as they work to enhance communication between patients and care teams and improve patient involvement in care planning and decision making. In addition, its efforts will foster key communication surrounding mandatory changes by federal payers such as the Centers for Medicare & Medicaid Services (CMS) and commercial insurers.
“Patient-reported outcome measures are becoming the standard of outcome evaluation and reimbursement throughout healthcare,” added Dr. Bozic. “By familiarizing themselves with the forthcoming changes and implementing the THA-TKA PROM-PM, if relevant to their practice, AAOS members will be one step closer to delivering a personalized medicine experience that puts patients at the center of decision making and delivers greater value.”
AAOS activities and solutions aimed at increasing the utilization of PROMs at the point of care will include: a PROMs user guide and other educational materials, webinars and publications, AAOS-endorsed technology solutions, a list of PROMs recommended by the AAOS for each specialty area, coding and reimbursement resources, among more.