To use PrOE, does the patient have to be in the Partner’s network with an EMR on record?

The patient does not need to be in the system prior to utilizing PrOE. The clinician can manually input information into the PrOE tool.

What do PrOE scores look like?

Some scores are more detailed than others, so it depends on what procedure you are looking at. All PrOE read-outs look like traffic lights: red for a poor outcome, yellow for a so-so or unknown outcome, and green for a positive outcome. However, some PrOE read-outs, like the cardiac procedure risk assessment, will give you a score based outcome on a scale of 1-9 where 1-3 is green (good outcomes), 4-6 are yellow (so-so or unknown), and 7-9 are red (poor outcomes). Your physician will always help you to understand what your PrOE score means.

What information is used to compile the risk calculations in the PrOE tool?

This depends on the specific risk calculator, but usually they’re statistical models looking at a patient’s demographic information like age, gender, race, and clinical factors like symptoms and medical history. For example, if a patient has preexisting conditions like CODP, diabetes, or high blood pressure these would be included in the statistical model because they can put you at higher risk for complications.

How does the PrOE tool access my information?

PrOE’s software platform QPID is integrated with our patients’ electronic medical records on EPIC. QPID uses natural language processing — like Google but for health records. It searches the patient record for defined key words and brings this information into the system to analyze. It is auto-populated for physicians so they can easily review the final information and manually add information that was unavailable or remove information that is irrelevant.

What types of questions are asked in PROMs?

In general, questions will ask you to rate information on a scale such as your severity of symptoms, how much your condition is impacting your life, or how much pain you are experiencing. The following is a question taken directly from the SAQ-7 Questionnaire used to measure the impact of chest pain or angina on your health and lifestyle. A similar question (how much limitation you have in a variety of activities) is also asked to patients experiencing knee pain or back pain. The most important thing to know about these questions is that they are not yes or no answers; they ask you to choose from a range of options depending on how severe your condition is.

The following is a list of activities that people often do during the week. Although for some people with several medical problems it is difficult to determine what it is that limits them, please go over the activities listed below and indicate how much limitation you have had due to chest pain, chest tightness or angina over the past 4 weeks. Place an X in one box on each line.*

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*Note: This is an example. Your doctor will provide you with the actual PROMs questionnaire

If my PROMs data is compiled with other patients, is personal information safe?

Yes, when PROMs are compiled to look at overall patient trends, specific patient information is no longer associated with individual scores. The scores become anonymous data points. Our data is compiled using secure systems that protect our patients’ data and personal information.

 

How many patients have submitted PROMs so far?

Over 200,000 patients have answered PROMs in 26 different departments and 65 different clinics across Partners HealthCare. Each of the graphs and procedures on the data section include a subset of these patients – this number is shown on the graph. Sometimes, we have been very specific about the procedure in question, for example looking at primary laminectomies that don’t include fusions or discectomies or other nuances. The more specific the analysis, the less patients included, which can better represent the particular procedure in question.

How does PROMs differ from standard quality measures collected?

Currently, standard quality measures include rates of infection and readmission to the hospital as well as many other metrics, which we measure as well. But Partners is among the first institutions who are trying to also measure the outcomes that matter most to patients such as whether we have reduced symptoms or improved function or quality of life. This is the future direction of quality measurement. It is a critical direction to focus health care on the patient’s well-being, and we are proud to be a pioneer in the field.

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