To watch the webinar, click here.

The 40-minute webinar (30 minute presentation followed by 10 minutes of questions) covers the following:

• What are PROs?
• How are they different from clinical measures?
• How are they used in the clinical setting?
• How are they collected and used?
• How do you get started with PROs?

The webinar also includes real-world case studies that highlight the use and benefits of PROs in various settings, including clinical, research and quality measurement.

Future webinars are currently being planned, so please check www.DynamicClinical.com periodically for details.

Chris Weiss

Co-founder, President

The first webinar – Patient-Reported Outcomes: What are they and how are they used? – will take place Tuesday, April 10, 2012 [...]]]> We’re excited to announce the first in a series of webinars designed to increase the health care industry’s knowledge of patient-reported outcomes and their ability to improve care quality, patient engagement and research.

The first webinar – Patient-Reported Outcomes: What are they and how are they used? – will take place Tuesday, April 10, 2012 at 3:30 p.m. EST. Lasting approximately 45 minutes (30 minute presentation followed by 15 minutes for questions), the webinar will cover:

• What are PROs?
• How are they different from clinical measures?
• How are they used in the clinical setting?
• How are they collected and used?
• Real-world case studies from clinical, research and quality measurement settings
• How do you get started with PROs?

Who should attend?

If you aren’t exactly sure what PROs are, or how they can be used to improve care quality, patient engagement and research, this is your chance to learn. Or, if you’re already familiar with PROs but would like others in your department or organization to have a better understanding of how they work, please feel free to invite them.

Anyone interested in attending can register by clicking here by April 6.

Hope to see you on April 10.

Chris Weiss

Co-founder, President

Over time, we have focused on continuously improving ISS by seeking out innovations in outcomes measurement infused with health care IT. [...]]]> Since we launched DCS in 2004, our primary product has been Integrated Survey System^® (ISS), a breakthrough patient-reported outcomes (PROs) solution that has developed a reputation as the most technically advanced platform available today.

Over time, we have focused on continuously improving ISS by seeking out innovations in outcomes measurement infused with health care IT. Along the way we’ve learned a lot about the uses and benefits of PROs, so much so that the time has come to expand our offerings by not one, but two new products: Patient Centered Quality Profile™ and OutcomesInsight™.

Patient Centered Quality Profile™

Patient Centered Quality Profile™, or PCQP™, helps health care organizations harness the power of PROs to measure care quality and patient satisfaction in ways that are much more effective than what exists in the marketplace today.

With PCQP health care organizations’ clinical and administrative leaders will be able to:

• Understand the relationship between care effectiveness and patient satisfaction;
• Identify strengths and weaknesses in providing effective care; and
• Translate effective care into higher patient satisfaction.

The result combines traditional patient satisfaction measures with patient-reported outcomes to create a decided marketing advantage for PCQP’s users.

OutcomesInsight™

By taking advantage of longitudinally collected, statistically valid patient-reported outcomes, OutcomesInsight™ facilitates outcomes comparisons between departments, providers, diagnoses, treatments, patient attributes, and even organizations.

With this information, clinicians and administrators are able to answer two of the most important questions they face:

• Are our patients getting better?
• How does the quality of our care compare to others?

With the answers to these questions in hand, opportunities to improve care, and ultimately, patients’ qualify of life, are easily identified.

We’re excited about these new products because both of them take what we feel is the next logical step in the evolution of PROs – making patient- and system-level changes that greatly impact the quality of care they provide.

I encourage you to learn more about Patient Centered Quality Profile™ and OutcomesInsight™ here.

Uwe Heiss

VP, RAD – Research Analytics Data

With CMS poised to release Meaningful Use Stage 2 requirements in the coming weeks, anticipation is building within the health care IT community.

Stage 2 could potentially be a very big step for health care as we may start to see many of [...]]]> Guest post by Uwe Heiss, Vice President, RAD – Research Analytics Data

With CMS poised to release Meaningful Use Stage 2 requirements in the coming weeks, anticipation is building within the health care IT community.

Stage 2 could potentially be a very big step for health care as we may start to see many of the benefits of EHRs besides just being able to do away with storage rooms full of paper. Whereas Stage 1 dealt primarily with laying the groundwork for successful implementation of a comprehensive, connected national EHR framework, Stage 2, according to information released by the ONC so far, will focus on using that framework to improve quality at the point of care.

We are proponents of electronic patient-reported outcomes (ePROs) because they improve the process of care, create better research, and take advantage of the patient perspective in care value measurement. Stage 1 didn’t have anything to say about ePROs, but we are keeping our fingers crossed that Stage 2 will lead to further use of ePROs by encouraging EHR vendors to create or adopt functionality that enables them.

So, what would we like to see in Stage 2? Here are four things we’ll be on the lookout for come release day:

Identification of a standard, patient-reported, population-wide health status measure

While the health care community has come to accept the value of patient-reported outcome measures, there is still no agreement on a standard instrument that is accessible and free to use for individual and population-wide health status measurements.

With several options available, we recommend that CMS endorse a standard and provide the framework for establishing outcomes comparability and transparency on a broad basis. By doing so, the industry will be able to more quickly take advantage of ePROs’ benefits as well as prevent setbacks by organizations that happen to pick instruments that down the road don’t become the standard.

Requirement to assess each active patient once a year for the purpose of generating a health baseline

The availability of a general health status baseline is highly valuable for understanding long-term trends and disparities in the population receiving care, as well as for assessing and guiding care of individual patients.

According to the ONC, Stage 3 will “focus on decision support for national high-priority conditions,” something that seems difficult to do without individual and population baselines.

Pre- and post-administration of the standard health status measure for all patients undergoing surgery

A surgical event represents a clearly marked treatment intervention, the outcome of which is relatively easy to assess using a pre-surgical baseline measurement and post-surgical follow-up measurements.

Surgery is one of the largest cost drivers in health care. Measuring the effectiveness of surgical interventions offers a high-impact starting point for eventually establishing outcomes measurement for all interventions. This would improve quality while helping to control costs.

Annual baseline assessment of the entire population affiliated with Accountable Care Organizations (ACOs)

ACOs will be held accountable for the health of their regional population, but how should the success of such stewardship be evaluated? Beyond establishing that the right care is delivered and that dramatic negative events are avoided, the most relevant measure is a patient-reported measure that quantifies, at the source, how well the patient is doing.

Since effective ACO care is also preventive, a comprehensive ACO compensation program will have to consider the health status for an entire ACO population, comprising both patients who are actively receiving care and those who currently do not. A standardized, patient-reported measure appears to be the best candidate for such a population-wide assessment.

As my colleague, DCS Co-founder and President Chris Weiss suggested in a previous blog entry, the key to ACO performance measurement is ePRO measurement.

We are looking forward to what CMS proposes for Stage 2. Once CMS draft requirements are published, check back with us to read our assessment.

In Implementing Accountable Care Organizations: Ten Potential Mistakes [...]]]> In a recent issue of JAMA, Sara Singer PhD, MBA and Stephen M. Shortell PhD, MPH, MBA, wrote an informative commentary about a topic that is receiving a lot of attention in the health care industry right now: Accountable Care Organizations (ACOs).

In Implementing Accountable Care Organizations: Ten Potential Mistakes and How to Learn From Them, Singer and Shortell discuss a number of things that could serve as potential roadblocks for healthcare organization’s making the transition to ACOs.

Potential mistake No. 3 is especially relevant to the work that Dynamic Clinical Systems has been engaged in since its founding in 2004: “The Overestimation of Ability to Report Performance Measures.” As health care moves from a fee-for-service to a pay-for-performance model, a lot of people are wondering exactly how performance will be defined and measured. It’s important because, after all, it will determine how and how much organizations and providers will get paid for the care they provide and thus how much health care will cost governments, payers and patients.

In assessing the performance measurement issue, Singer and Shortell write that “experience with pay-for-performance programs suggests the challenge of collecting, analyzing, and reporting performance data” and “will depend on the ability of electronic health records to reliably document the delivery of clinical care.” The authors suggest that the solution can be found in the “development of a mature performance measurement system.”

Their analysis is dead-on, but I’d suggest that they are mistaken in one small area: a mature, performance measurement system already exists: patient-reported outcomes or PROs.

PROs are well suited for ACOs because, as we outlined in a previous blog post Breaking Down the Wall, clinicians trust the scientifically valid measures that they create. This validity should make it easier for payers to feel comfortable about using them to determine reimbursements.

But more importantly, the essence of PROs – asking the patient how she is doing before, during and after treatment – is synergistic with the overarching concept of ACOs, that paying for better outcomes will lead to better care.

I can’t imagine an outcome more desirable than a patient’s quality of life improving because of the care they receive. But how do you determine that? It’s simple; just ask the patient.

That’s what PROs have been doing in both clinical and research settings for decades.

Chris Weiss

Co-founder,  President

While both clinicians and patients have [...]]]> One of the great promises made by the introduction of information technology (IT) to health care has been the idea that through IT, clinicians and the patients they care for can better engage in an ongoing interaction that makes each side better informed about symptoms, treatments, expectations and outcomes.

While both clinicians and patients have more access to health care IT than ever before, advancements on both sides of the equation have taken place largely separately from each other and have actually created barriers to better communication.

Before we tackle how to get them talking to each other, here is one person’s view of the evolution of consumer-driven health IT.

Clinicians

The adoption of electronic health records (EHRs) has been steadily increasing in the past ten years, and has recently jumped considerably since the federal government began incentivizing adoption (and beginning in 2015, penalizing the failure to do so). The efficacy and merits of EHRs are hotly debated and there are strong opinions on both sides, but it is pretty easy to make the case that the current iterations of the technology do not effectively engage patients.

In most cases patients do not have easy access to their own electronic health records and do not provide much input into their records of their own accord. The way EHRs are currently configured is decidedly one sided: clinicians input, interpret, and use the information without much if any input from patients at all.

Patients

As patients have become more comfortable with IT in all facets of their lives, they’ve naturally used it increasingly for their health care needs as well. The first form of IT used by patients to take a more active role in their health care were online repositories of health information such as WebMD or organization-sponsored websites such as the highly regarded one developed by the Mayo Clinic. Today, searching for symptoms, diagnosis and treatments online is probably the first thing people do when a serious health issue arises.

The second generation of patient-facing healthcare IT was the personal health record (or PHR), as developed by the recently closed Google Health and Microsoft HealthVault. In many ways, these services and others like them sought to replicate medical records that have been traditionally kept only by clinicians. In the case of the PHR, patients enter and detail their own records, with some limited (if any) integration with clinical systems.

And even more recently, websites such as PatientsLikeMe have sought to use the power of crowd sourcing to diagnose illnesses, determine treatment and build a sense of community around those with similar health issues.

It’s important to note that both patient-driven electronic health records and social sites are positive developments because anything that actively enlists patients in working toward better health outcomes is a good thing.

However, they don’t do a great job of facilitating true patient engagement. They have simply created even more data that is not shared between patients and clinicians. That’s not to say these data cannot be shared with clinicians, but the numerous formats in the marketplace and their untested clinical relevance make it unlikely that clinicians will fully use them in their evaluation and treatment of the patient.

Breaking Down the Wall

So how can we properly use health care IT in a way that engages patients and will be trusted and understood by clinicians? Fortunately, the answer is already in wide use in health care: electronic patient-reported outcomes or ePROs (for a brief description of patient-reported outcomes and their uses, visit here).

ePROs are excellent measurement and engagement tools because they solicit feedback from patients in ways that are easy to use and understand, properly spaced through a course of treatment, structured, and can also trigger educational or intervention actions like scheduling a visit with a specialist or providing the patient with health information such as smoking cessation advice.

Clinicians value ePROs that generate trusted, scientifically validated results. Additionally, in normal care settings, ePROs can improve the process of care by highlighting red flags and providing easy-to-understand measurements, including charts and bar graphs, that help clinicians explain treatment options and outcomes to patients.

In short, ePROs provide what each side of the patient-engagement spectrum is looking for. Patients are asked about their health and are provided a chance to contribute to their medical records. Clinicians receive data that are scored and normed in real time, compared longitudinally and are easily exportable for integration and reporting. And with increasing focus on these measure in Meaningful Use, we are likely to soon see adoption accelerate.

The conditions are ripe for the health care industry to take a quantum leap forward in true patient engagement. Both clinicians and patients are eagerly seeking better outcomes through IT and, with a greater adoption of ePROs, we have the opportunity to link those two sides together as never before. Now is the time to make it happen.

Chris Weiss
Co-founder, President

The Dartmouth Institute for Health Policy & Clinical Practice (TDI) recently released a As more and more health care organizations adopt EHRs, attention is increasingly being paid to how best to integrate these information systems into the process of care, and ultimately, how to use them to provide better value and care.

The Dartmouth Institute for Health Policy & Clinical Practice (TDI) recently released a report that highlights what some of the leading health care systems have done to get the best out of their EHRs.

The benchmarking performed by this report is an important step in health care’s HIT evolution because, as TDI suggests, the act of installing EHRs in-and-of-itself doesn’t necessarily lead to better outcomes: “The experiences of leading health systems who have already made massive investments in HIT during the past decade suggest that simply implementing today’s EHR packages – without making further changes in the way care is designed, delivered, analyzed supported and measured – will not necessarily achieve the aims of improving the quality and value of care.”

Besides being informative reading, I found two additional reasons to like this report: it was co-written by Dynamic Clinical Systems co-founder, Lisa Torrey Weiss, who in addition to her role at DCS also works with TDI on special projects; and, it highlights Dartmouth-Hitchcock Medical Center’s use of our patient-reported outcomes solution, Integrated Survey System® (ISS).

The report details how Dartmouth-Hitchcock augments its EHR by using ISS (called ePRO by Dartmouth-Hitchcock) across 18 specialties to collect hundreds of thousands of patient health questionnaires that “tailor education for the individual patient; create a clinical summary for use at the point-of-care, including longitudinal health score graphs and red flags; generate auto-referrals to specialists based on patient questionnaire responses; and automatically schedule a series of future questionnaires to monitor patient health and outcomes post-intervention.”

To be sure, it is an exciting time for HIT. But, as TDI points out, it isn’t necessarily HIT itself that will finally deliver on the promise that many of us have dreamt about for years. It’s what you do with it that really matters.

Chris Weiss

Co-founder, President