In the world of management there is a mantra that guides all decisions: What is not measured cannot be improved. This principle reminds us to approach our challenges with an analytical stance, replace intuition with hard data and implement measurement techniques that help us know in a timely manner if we are on the right track.
In healthcare, this principle is of vital importance. Health professionals rely on empirical evidence every day to discover new treatments and optimize their decision making in order to save more lives and improve patients' quality of life.
Measuring a patient's well-being after a treatment is fundamental to understand the effectiveness of that intervention. The value that any therapy has for a patient is given by his or her ability, to the greatest extent possible, to have a normal life. In other words, to be able to move with autonomy, cook, work or play sports again.
When it comes to measuring a patient's quality of life, the best source for that is the patient himself. Now, although we can ask the patient "how are you feeling?", how can we make this measurements continuous and not only at the healthcare provider's side?
The solution to this are Patient-Reported Outcome Measures (PROMs). PROMs are questionnaires that patients can self-complete.
In this article we will analyze how these measurement tools help close information gaps and quantify the impact that medical care has on the well-being of patients.
PROMs are a fundamental tool for understanding the before and after of a patient and putting their needs and preferences at the center of their care. While their use was born as a measurement tool in clinical trials, public and private hospitals around the world use PROMs to gain a holistic view of the patient experience.
At a macro level, PROMs are used to evaluate the performance of departments within a hospital and to facilitate benchmarking between different health services for the same specialty.
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According to the researchers Charlotte Holmes and Norman Briffa, University of Sheffield, the quality and usefulness of a PROMS instrument may be measured by the following criteria:
Validity is the ability of the questionnaire to accurately measure the intended outcome, in other words, those who score poorly are indeed in poor health. A PROMs' validity may be measured by three aspects:
The results obtained with the questionnaire are consistent when repeated in the same population at different time points.
This criteria assesses whether the instrument can detect changes over a time period that matter to patients.
Lastly, this criteria assesses whether the changes that an instrument can measure are clinically significant and is specific to the condition and intervention being investigated.
When it comes to collecting PROMs, it is essential that they are collected electronically and on a platform that safeguards the privacy of patient data. Electronic questionnaires allow to eradicate the common problems associated with paper forms and to generate a user experience that is appealing for patients.
In recent years, mobile data collection applications have emerged, such as Teamscope, which allow patients to track their symptoms directly from their smartphones. Mobile forms, coupled with push notifications, are proven to increase engagement with the patient and thus achieve timely monitoring (Belarmino et al.).
Achieving personalized health care can seem like a titanic task. Especially in high demand health systems. If there's one thing you can start with, is improving the communication channels we have with patients.
Patient-completed clinical questionnaires are a cost-effective tool to innovate the way we communicate with the patient, measure their well-being during and after treatment, and have mechanisms to know if at the end of the day, we are actually on the right track.